- What is Senate Bill 106?
- Senate Bill 106 was a bill requiring that commercial insurance cover bariatric surgery. It was sponsored by Louisiana State Senator Regina Barrow and signed into law by Governor Jeff Landry on June 24th, 2024.
- When does the law take effect?
- January 1, 2025.
- Does the law apply to Medicaid or Medicare?
- No. Medicaid and Medicare are public health insurance carriers. Both currently cover bariatric surgery with some limitations.
- My insurance did not cover bariatric surgery before. Will it now be covered?
- The new law will make coverage for bariatric surgery available to more than a million Louisiana residents who did not have coverage before. Individuals must have certain health criteria to qualify.
- Does any Louisiana resident with commercial insurance now qualify for bariatric surgery?
- No. Patients must have a Body Mass Index (BMI) greater than or equal to 40 or a BMI of 35 -39.9 with an obesity-related illness to qualify. There may be other eligibility requirements which will be detailed in your individual policy.
- Does the law require Louisiana employers with self-insurance to include coverage for bariatric surgery?
- No, but they may opt to include it.
- Does the law require coverage for anti-obesity medications?
- No.
- How do I determine if my commercial insurance will cover bariatric surgery?
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Investigate your insurance coverage prior to the open enrollment period to obtain answers for the following questions from your benefits office:
- Will my insurance plan cover bariatric surgery starting 2025 based on this new law?
- Will there be other plans that offer bariatric surgery?
- When is the next benefit enrollment period?
- Is my employer self-insured? If so, ask the benefit manager if they plan to opt in to bariatric surgery coverage in 2025.
For many employees the annual benefit enrollment period occurs in the Fall. As your benefit enrollment period approaches you should receive information about your health insurance policy options. Carefully read the coverage, paying attention to the surgery coverage and the exclusions to coverage. If your employer offers more than one policy option, carefully compare the options. Employers who are self-insured are not required to provide bariatric surgery coverage, but they may opt to include it. Contact your employee benefits office for assistance.
Ready to seek more information about bariatric surgery?
