Does Medicare Cover Gastric Bypass Surgery?

Mike Olmos by Mike Olmos | Licensed since 2010

This article was updated on: 09/10/2018

If you meet certain criteria and your doctor determines the procedure is medically necessary, then Original Medicare, Part A and Part B, may cover certain types of gastric bypass surgery. Typically this surgery is only approved for beneficiaries when previous medical treatments for extreme obesity have been unsuccessful. Also, patients must have a body mass index > 35 and at least one co-morbidity or condition related to obesity, such as type 2 diabetes.

You may have to pay the Medicare Part A and/or the Part B deductibles before Medicare will pay, plus you may need to pay copayments. The procedure must be performed at a Medicare-approved facility. So before scheduling this surgical procedure, you should get an estimate of costs and find out what your coverage options are.

If you are able to get gastric bypass surgery covered by Medicare, you might consider expanding your Original Medicare with additional insurance, such as a Medicare Supplement plan (Medigap) to help pay for deductibles and copayments. Or you may be interested in a Medicare Advantage plan (Medicare Part C), which has the same coverage as Original Medicare and may offer more benefits.

I can help you find Medicare plan options in your area that may give you more coverage than Original Medicare.  Learn more about me through my profile below; just click the “View profile” link below. Feel free to let me know if you’d like to discuss anything with me by phone or email; the links for requesting those are below as well. Click on the Compare Plans buttons on this page.

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