Bariatric Surgery

TRICARE covers the following open or laparoscopic bariatric surgical procedures:

• Roux-en-Y gastric bypass
• Vertical banded gastroplasty
• Gastroplasty (stomach stapling)
• Adjustable gastric banding (adjustable Lap-Band^®)
• Biliopancreatic diversion with or without duodenal switch for individuals with a body mass index greater than or equal to 50 kg/m²
• Sleeve gastrectomy
• Stand-alone laparoscopic sleeve gastrectomy

You must meet all of the following conditions to qualify:

• You’re at least 18 years old or you must provide documentation of completion of bone growth.
• You were unsuccessful with non-surgical medical treatments for obesity. Your medical records must show your failed attempts.
  • Diet programs, such as Weight Watchers^®* and Jenny Craig*, are acceptable methods of dietary management, as long as you have monthly clinical visits with your doctor and medical documentation of your participation and your progress throughout the course of the dietary program. *TRICARE doesn’t cover these programs.
  • Physician-supervised programs made up of only weight-loss medication management don’t meet this requirement.
• You have proof of one of the following:
  • A BMI greater than or equal to 40 kg/m²; or
  • A BMI of 35–39.9 kg/m² with one clinically significant comorbidity, including but not limited to, cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnea, Pickwickian syndrome, hypertension, coronary artery disease, obesity-related cardiomyopathy, or pulmonary hypertension.

TRICARE doesn’t cover the following services:

• Office visits solely for the treatment of obesity
• Non-surgical procedures for treatment of obesity
• Nutrition and diet counseling
• Biliopancreatic bypass (jejunoileal bypass, Scopinaro procedure)
• Gastric bubble or balloon
• Gastric wrapping and open gastric banding
• Unlisted procedures

Active Duty Service Members

Bariatric surgery is a permanent change in your digestive system that requires following a specific diet plan that may interfere with operational deployment. Active duty service members who have bariatric surgery can’t reenlist. Service members who receive bariatric surgery while on active duty may be separated. 

For more information, view the Health Affairs Policy 07-006.