Does Medicare Cover Bariatric Surgery?

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

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.