Need help paying for surgery?
If your plan won't cover the full cost — or you don't have insurance — we offer flexible financing options to bridge the gap.
Insurance & coverage
Insurance & coverage, made clear.
Weight-loss surgery is covered by most major insurers — and we verify your benefits before you commit to anything.
How coverage works
Most patients are covered.
We work with most major insurers, and accept Medicare and Medi-Cal. Weight-loss surgery is covered when medical criteria are met. Coverage details vary by plan — which is why we verify your specific benefits before you make any decisions.
Insurances we accept
We work with most major insurers — including Medicare and Medi-Cal. Coverage and requirements vary by plan, so our team will verify your specific benefits for you before your consultation.
Medicare
Medi-Cal
Partnership HealthPlan
Providence
Aetna
Blue Shield PPO
Anthem Blue Cross PPO
BariNet
United Healthcare PPO
UMR
Cigna
Lantern Specialty Care
This list reflects plans we commonly work with and may change. Acceptance of an insurer does not guarantee coverage for a specific procedure — coverage depends on your individual plan. We verify your benefits before treatment.
Don't see your plan, or not sure what's covered? Verify your benefits — free
We also accept self-pay, and offer financing.
Before you call
What to ask your insurance company.
When you call your insurer, write down the answers so you have a clear record.
1
Name of the representative
The person you spoke with, in case you need to reference the call later.
2
Date and time of the call
Helps with follow-ups and tracking approval timelines.
3
Call reference number
A unique ID that lets anyone at the insurer pull up the details instantly.
4
Which bariatric procedures are covered
Ask specifically about sleeve, bypass, band, balloon, and any prior-authorization rules.
5
Criteria you must meet for coverage
BMI thresholds, required documentation, and any mandatory diet or evaluation periods.
Understanding requirements
Common insurance requirements for bariatric surgery.
Insurers' criteria vary, but most follow guidelines aligned with the American Society for Metabolic and Bariatric Surgery (ASMBS).
BMI 40 or higher
The most widely recognized threshold across commercial plans, Medicare, and Medi-Cal.
BMI 35–39.9 with a condition
Type 2 diabetes, sleep apnea, hypertension, or heart disease may qualify you under this range.
BMI 30–34.9 with type 2 diabetes
Newer ASMBS guidelines recognize metabolic surgery for patients in this range with uncontrolled T2D.
Additional requirements
A psychological evaluation and a physician-supervised diet program (often 1–6 months) are commonly required.
These are general guidelines based on ASMBS criteria. Each plan differs — our office verifies your specific requirements before your consultation.
What insurers typically require
General medical-necessity criteria.
Most insurers use criteria similar to those below to determine eligibility for weight-loss surgery. These are general guidelines, not a guarantee — specific requirements vary by plan.
BMI threshold
Typically a BMI of 40+, or 35+ paired with a weight-related condition such as type 2 diabetes, hypertension, or sleep apnea.
Documented attempts
Most plans want a record of prior medically supervised weight-loss attempts. We help you compile what's needed.
Medical-necessity letter
Documentation from your surgeon confirming that surgery is appropriate for your health and history.
Educational guidance only · Not a coverage determination
We verify your benefits for you
No guessing. No surprises.
Our program coordinator confirms your weight-loss coverage with your insurer before scheduling your consultation, so you get the most current coverage information available — up front, in plain language.
- Coverage verified before scheduling
- Clear written summary of benefits
- Help compiling required documentation
- Appeal support if coverage is denied
Verification request
Verify my benefits
Submit your information and our coordinator will reach out — usually within one business day.
Frequently asked