Will my insurance pay for an ESG?
To answer questions about an endoscopic sleeve gastroplasty (ESG) procedures and insurance coverage, typically the first place to begin is with a review of your health plan’s coverage for bariatric procedures. If you have a copy of your specific health plan you can look to see if there is bariatric coverage and if so, what the requirements are for obtaining this coverage. If you do not have a copy of your plan, you may wish to contact your insurance company and discuss coverage and ask that they send you a copy of your coverage.
In the case of the ESG procedure, many insurance companies provide no coverage. When coverage exists, often the insurance company considers payment for the procedure, provided the patient has met a number of specific criteria. In particular, this is often the case with Medicare.