Does Humana Medicaid Cover Bariatric Surgery?

Does Humana Medicaid Cover Bariatric Surgery? Would you like to know the answer to the question “Does Humana Medicaid Cover Bariatric Surgery?” You are in the right place.

Your Humana Incuranse will cover bariatric surgery, unless stated otherwise in your policy. In fact, Humana already has its own Bariatric Management Team.

This Bariatric Management Team is ready to guide you through your weight loss surgery. In addition, you will be able to benefit from this team for 6 months after the operation.

Humana’s Pre-Approval Requirements are:

Body mass index 40 and above

Or having a body mass index of 35 to 39 along with one of the following:

Type 2 diabetes,
Severe Sleep Apnea,
Joint Disease,
Weight loss surgery confirmation letter from your doctor,
A 6 month weight loss program,
Be over 18 years old,
Psychological evaluation.

Types of bariatric surgery that humana covers include:

Gastric bypass surgery
Lap Band or Realize Band Surgery (Generally Lap Band fills are covered at in-network providers.)
Sleeve Gastrectomy
Duodenal Switch Surgery

However, the actions that Humana will not cover include:

Mini gastric bypass
Gastric plication with gastric band etc.

Another requirement of Humana Medicaid is that bariatric surgery be performed in an accredited Center of Excellence.

In addition, it is not necessary for an intranet bariatric surgeon to perform your surgery, but this is the recommended method. Because the amount that Humana will pay for the surgery performed by the in-network bariatric surgeon will be higher than that of the out-of-network bariatric surgeon. Therefore, if you go to an in-network surgeon, the cost you will pay will decrease.

If you have Humana insurance and are going to have bariatric surgery, we recommend contacting Humana’s Bariatric Management Team.

How Does Humana Medicaid Cover Bariatric Surgery?

Even if some plans of your insurance company cover bariatric surgery, this does not mean that your particular plan covers bariatric surgery.

We list the bariatric surgery approval conditions that we will list in this article, assuming that weight loss surgery is covered by your private policy.

You can contact a surgeon to find out if your private policy covers bariatric surgery. Or you can contact your insurance company directly.

In the United States, you must meet the following criteria:

You must be over 18 years old.

A specialist should diagnose you with morbid obesity.
So your Body Mass Index (BMI) must be over 40

Or you must have a BMI of 35 to 39.9 and also have one of the following:

Severe sleep apnea

Pickwick syndrome


Type II diabetes

Cardiovascular disease

Cardiopulmonary problems

When you apply to Humana to cover your bariatric surgery, a bariatric nurse is assigned directly to you.

A bariatric nurse on Humana’s Bariatric Management Team will check if you meet the medical criteria. If necessary, the nurse will consult with the bariatric medical director. It will also check if the surgeon’s bariatric hospital has been certified as a Center of Excellence by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Because we said earlier that this is a prerequisite.

For best results, the hospital and surgeon you choose must be in your health plan’s network.

We recommend that you call the Bariatric Management Program to find out if your surgeon and hospital meet the coverage criteria for your plan.

What Issues Will The Bariatric Nurse Help You With?

The bariatric nurse will help you determine if you are suitable for surgery and what your options are. In addition, other topics that will help you are as follows:
It tells about your financial obligations and offers you solutions to meet them.

Shares training videos to help you prepare for surgery.

It gives you information that will help you to protect your health before and after the surgery.

Nurse will help you in your recovery process after surgery.

They make an appointment for you from the health personnel you need.

Nurse answer any of your questions.

They will continue to provide these services for six months after surgery.

If Your Policy Doesn’t Cover

If your policy does not cover bariatric surgery, you can request partial coverage. In this case, even if your insurance does not cover the entire weight loss surgery, it will be able to cover some of the costs you will make. The important thing here is the communication between your doctor and the hospital with your insurance company.

For example, cardiology test, without using the weight loss surgery CPT code,
laboratory work, diet program, psychological assessment, your insurance will cover them if they request services such as sleep testing.

However, your doctor will code your weight loss surgery CPT insurance will not cover these claims. However, if your doctor uses a generic CPT code, they will likely meet it.

This practice is ethical, even if it doesn’t look like it. Because even if you do not continue your treatment with surgery, you will need to receive these services.

If your insurance does not cover weight loss surgery despite what we have listed above, it is probably not in your policy.

First, you should check with your surgeon to be sure. It will contact your insurance company for you free of charge. Don’t worry, surgeons and their offices are in contact with insurance companies. Therefore, they know very well how the process works.

If your surgeon concludes that your policy does not cover bariatric surgery, you can ask for a tip to reduce the cost.

For detailed information on this, you can check our other articles. However, you can find a lot of useful information about it on the internet.

If these tips don’t work for you, our advice would be to make changes to your insurance company or policy.

As A Result

If you meet all the criteria mentioned above, don’t worry, your insurance will cover your obesity surgery. We have mentioned a little about what you can do if you don’t. However, if these are not enough, we recommend that you consult with your surgeon first. So he has every detail that can help you with this.

Financially, How Much is Weight Loss Surgery in Las Vegas?


Weight loss surgery, also known as bariatric surgery, is a life-changing option for those struggling with obesity. It can be difficult, but many Las Vegas people undergo bariatric surgery to lose weight and improve their overall health. The natural question that pops into one’s head is, “how much is weight loss surgery in Las Vegas?” It varies depending on the type of procedure, the hospital or clinic performing the surgery, and the patient’s insurance coverage.



Weight loss surgery Las Vegas cost may be lower or higher depending on the type of procedure chosen, the hospital or clinic performing the surgery, and whether insurance covers any of the prices; some surgeons may offer financing options to help cover the cost.


For uninsured people or whose insurance does not cover bariatric surgery, there are options available in Las Vegas to help make weight loss surgery more affordable. Discounts may be available through hospitals or clinics specializing in bariatric surgery, as well as online resources such as medical tourism agencies that can help connect patients with clinics abroad. Some Las Vegas non-profit organizations also provide grants and other financial assistance for individuals. We hope this article helped answer “how much is weight loss surgery in Las Vegas?”