Yes, Medicare covers bariatric surgery — but only under specific conditions. You must have a BMI of 35 or higher, at least one serious obesity-related health condition, and documentation that your doctor has managed your obesity for at least 6 months without success through nonsurgical means.
Approved Bariatric Procedures Under Medicare
- Roux-en-Y Gastric Bypass
- Laparoscopic Adjustable Gastric Banding (Lap-Band)
- Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
- Sleeve Gastrectomy (gastric sleeve) — covered at facilities with approved bariatric programs
Eligibility Requirements
| BMI requirement | 35 or higher |
| Co-morbid condition | Must have type 2 diabetes, hypertension, or another serious obesity-related condition |
| Prior treatment | At least 6 months of physician-supervised weight loss efforts documented |
| Facility certification | Surgery must be performed at a Medicare-approved bariatric facility |
What Medicare Pays For
- The surgical procedure (Part A for inpatient, Part B for outpatient)
- Pre-surgical consultations and lab work
- Post-surgical follow-up visits
- Nutritional counseling related to post-surgery recovery
What Is Not Covered
- Weight loss programs not directly tied to surgical preparation
- Weight loss medications
- Surgery for cosmetic purposes or BMI under 35 without comorbidities
The Pre-Authorization Process
Medicare requires prior authorization for bariatric surgery at most facilities. Your bariatric surgeon’s office typically handles this, but you should confirm the facility is Medicare-certified and that all documentation is submitted before your scheduled date.
Part of our Medicare Guide. Costs, enrollment deadlines, Medicare Advantage vs. Medigap, Part D and what Medicare covers, all in one place. See the full guide →
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