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Kaiser Permanente Covers Weight Loss Surgery

To qualify for coverage of weight loss surgery, your policy must include coverage. Not all policies include coverage. To find out if you policy includes coverage, please talk direclty to Kaiser Permanente.

Kaiser Permanente covers weight loss surgery. Gastric bypass, lap band, and gastric sleeve surgery are all covered by Kaiser Permanente assuming you meet the requirements listed below.

Kaiser Permanente Requirements for Coverage

Surgery is a tool for the severely obese who cannot lose weight through the traditional means. Kaiser Permanente covers weight loss surgery in most cases, assuming you meet the requirements below.

  1. Body Mass Index of 40 or greater, OR
  2. Body Mass Index of 35 or greater with at least one major comorbidity.
    1. Comorbidities may include severe sleep apnea, high cholesterol, diabetes, etc.
  3. Over the age of 18.
  4. Completed a medically supervised weight loss program within the last two years.
  5. Have been morbidly obese for at least 3 of the last 5 years. This should be documented by a physician (i.e. annual visits to your OB/GYN, etc.)
  6. Successfully completed a psychological exam. There are no issues that may make it difficult for you stick to your new diet and lifestyle post-surgery.

Types of Weight Loss Surgery Covered By Kaiser Permanente

Kaiser Permanente covers the most commonly covered weight loss surgeries. They are listed below:

  • Gastric bypass
  • Lap gastric bands (Lap Band and Realize Band)
  • Gastric sleeve surgery (Sleeve gastrectomy)
  • Duodenal switch surgery

Procedures not covered by Kaiser Permanente include:

  • Trans-oral stapling procedures
  • ‘Mini-Gastric bypasses’
  • Gastric plication with or without a gastric band

Are gastric band fills covered?

Yes. Lap band fills are covered if your original procedure was covered by Kaiser Permanente.

Do I have to have Obesity Surgery at a Kaiser Facility?

Yes. As with most things with Kaiser you need to stay in-house and have the procedure at a Kaiser facility.

Contact Information for Kaiser Permanente

Sign on to the Kaiser website and contact them here.

 

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