Hi y'all! I'm new here well, I joined a few years ago and never interacted, and haven't gotten surgery yet.

A little about me.

I have PCOS and chronic migraine syndrome. My BMI is about 55. With that being said, I'm looking into surgery and have found an amazing surgeon. I'm shopping around for insurance. I found a plan, and the surgeon is covered, but the plan says bariatric services are not covered (I'll post a screen shot of them) Any idea of why that could be? Would I need to go see the surgeon and have him talk to my insurance and they would need to approve me? I'm so confused lol

I believe your plan does not cover Bariatric surgery.. I don’t know if it is with him .. or your plan.. best you can do is to call your plan and ask them directly. And what hospitals, if they do, is acceptable for Bariatric through your plan.


“There will be obstacles. There will be doubters. There will be mistakes. But with hard work, there are no limits.” —Michael Phelps

It looks like your plan specifically excludes bariatric surgery, so you could see this doctor for general surgery and be in-network, but not bari.

Don't give up. Go to him and then write to your insurance company about why you need WLS, have his office back up your request. My plan doesn't cover WLS, but I persistently challenged and they came through.

Thank you all! I've decided to go with Dr Illan at BariatricPal MX!