Does Medicaid Cover Weight Loss Surgery in Texas?

Mar 29, 2022

In many cases, weight loss surgeries become necessary for patients. Dealing with obesity is tough, leading to various health problems. Moreover, obesity can get out of control. Many have gone for alternative weight loss programs and management with no luck. Sometimes weight loss surgery can be the only solution to achieve a healthy weight and lifestyle.

Weight loss surgeries can be costly and many people may not be able to afford it. The cost for bariatric surgery depends on the type of surgery, location of the surgery, and the patient. Generally, the surgery could cost around $17000 to $30000.

Medicaid does cover weight loss surgery in Texas, as long as the patient is eligible according to the criteria for coverage. Each state is individual in their Medicaid coverage, and you have to verify with Texas State to see what their coverage is. Weight loss surgeries are not extensively mentioned in the rules and guidelines for Medicaid coverage but are handled separately for different cases. It is important for you to work with your physician to discuss the approval process for Medicaid coverage. You can get in touch with Dr. Mustafa H. Alibhai, MD, FACS, FASMBS to learn more about bariatric surgery treatment.

Weight Loss Procedures Covered By Medicaid

In most cases, Medicaid covers gastric bypass, gastric sleeve surgery, and Lap-Band Surgery. These are not only easily converted by Medicaid, but also among the most standard surgeries recommended. In certain cases, these are accepted as medically crucial to the life and well-being of an individual.

How Much Coverage Does Medicaid Provide?

Generally, if the surgery is covered under Medicaid, there will be full coverage provided. If there is some part of the operation that is not under coverage, then you may have to look for other supplemental insurance or gap insurance to cover the surgery, once you are approved by Medicaid. This could help to advance through coverage of any remaining balance with other insurance companies.

What Is the Process of Medicaid Approval for Weight Loss Surgery?

If the Medicaid provided by Texas or any state you are from covers weight loss surgery, you should consult your physician. It is important to have a physician who can share vital information for the medical necessity of weight loss surgery for the patient. Further, a physician can also recommend the patient to approved surgeons. At Nova Bariatrics, we have experienced approved bariatric surgeons Dr. Gulamhusein and Dr. Alibhai who can help you with the treatment procedure.

Approved surgeons help you understand the basics of the surgery and the various options at your disposal. After taking the decision, you have to go through certain tests and then consult the Medicaid office for the pre-approval of your surgery. The process can take some time and requires patience. Prior to approval, you may need to attend classes to gain knowledge about the surgery, lifestyle changes, exercise, nutritional needs, and so on. These are important for post-operative care. This ensures that the patient understands and agrees to all the implications of bariatric surgery and what is important to make it successful.

With all the necessary provisions, chances are you will get approval from Medicaid. These provisions can then include other additional classes or more testing. After Medicaid approval, your surgeon has to determine if you are fit to undergo the procedure. This includes medical prep, X-rays, and blood tests. And then, finally, the surgery is booked. Hence, you take a step closer to a healthier lifestyle and your body weight goals.

It can be difficult to determine what part of your surgery will be covered by Medicaid in your area. You can check the same with the local Medicaid office to see where this information can be available for you. Make sure that if there is a requirement to choose an approved surgeon, you have a list of these surgeons.

If you are on the lookout for weight loss surgery doctors near me, you can contact us to know more about the treatments available, and what is best for you.


Dr. Mustafa H. Alibhai

Dr. Alibhai, a board-certified general surgeon, passionately leads Nova Bariatrics and General Surgery. Formerly an Assistant Professor at McGovern Medical School, he’s a Fellow of the American College of Surgeons and the American Society of Metabolic and Bariatric Surgeons. His academic journey includes a Bachelor’s from Southern Methodist University, Medical School at UT Southwestern, and residencies at UT Southwestern. Specializing further, he completed Bariatric and Robotic Fellowships, advancing surgical techniques with a focus on patient well-being.



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