Finer Balances for the Bariatric Surgeries

You have hired a health plan, or intend to, but do not know if it covers bariatric surgery. The answer to the question whether health insurance covers bariatric surgery is yes. This is a procedure that must be included in the mandatory minimum coverage to be ensured by the plans. You also need the food tracker after that.

Scale image to illustrate text about health plan covers bariatric surgery

This is an event foreseen in the Procedural Roll published by the National Agency of Supplementary Health (the company), which regulates the activities of the sector.

Do you want to know more about how this coverage works, the techniques contemplated and the indicated cases? Let’s look at all of the following information, including when the health plan covers bariatric surgery. The use of the weight tracker comes easy there.

How do health insurance coverage work?

Before hiring a health plan, it is important that the person concerned knows that there is a specific instrument that covers the coverage that should be offered by health care providers.

This document is prepared by the company. It has a role as a health insurance regulator in Brazil. The entity is linked to the Ministry of Health.

the company creates standards, controls and supervises the market segments operated by companies in order to ensure the public interest. All this information is gathered in the Health Procedures and Events Rol. The Rol acts as a basic reference for the minimum mandatory coverage offered by private health plans. The food and weight tracker comes easy there.

Does health plan cover bariatric surgery?

To answer the question if health insurance covers bariatric surgery you need to understand a few things. Bariatric surgeries are provided for in the the company-regulated Health Procedures and Events Schedule. Thus, bariatric surgeries should be covered by health plans.

  • This type of procedure is part of the minimum mandatory coverage to be provided by private plans called “new plans” and adapted “old plans”. In changing eating habits this is important now.
  • Failure by health care providers to comply with these requirements may result in punishment with fines and may even be prosecuted.

What do I need to know about bariatric surgery coverage?

Despite being an event provided for in the minimum coverage roll, there are some guidelines that indicate characteristics and health conditions of the patient. These are characteristics that the company understands to be relevant to the clinical results of the procedure.

Therefore, health plans should be guided by these guidelines for the conduct of each case. According to the company, bariatric surgery is indicated for obese patients who, despite having been subjected to clinical treatment with medications and lifestyle changes, did not have satisfactory answers. Below are other requirements that define whether health insurance covers bariatric surgery or not.