Does insurance cover weight-loss injections or bariatric surgery?
The Insurance Regulatory and Development Authority of India (IRDAI) issued a landmark circular in October 2020 that made it mandatory for all health insurers to include coverage for medically necessary bariatric surgery under certain conditions.
As per the guidelines: 'Bariatric surgery shall not be excluded when it is medically necessary and prescribed by a medical practitioner for treatment of obesity and co-morbid conditions.' BMI ≥ 40 (morbid obesity) without comorbidities, or
BMI ≥ 35 with serious co-morbidities, such as type 2 diabetes, hypertension, obstructive sleep apnea and heart disease
This move was a big shift, as earlier, most insurers treated bariatric surgery as a cosmetic or elective procedure. Now, if these medical thresholds are met, hospitalisation costs and surgery can be covered, subject to policy terms, waiting periods, and exclusions.
In contrast, anti-obesity injections — such as GLP-1 receptor agonists like Semaglutide (Ozempic/Wegovy) and Liraglutide (Saxenda) — are still not universally covered.
But, Ozempic (Semaglutide) is approved in India for Type 2 diabetes. If prescribed as part of diabetes management, it may be covered under policies that allow outpatient benefits or chronic care riders. Saxenda, which is approved abroad for weight loss but not yet widely approved for obesity in India, is typically not covered, especially for standalone weight loss.
Most policies still exclude weight-loss medications under general exclusions unless they are part of the treatment of a covered illness.
Review your policy documents for clauses around bariatric surgery and chronic condition riders.
If you have Type 2 diabetes, PCOS, or cardiovascular risk, and have been prescribed GLP-1 injections, you may request pre-authorisation or medical necessity documentation and check
The 2020 Irdai directive opened the door for medically necessary bariatric surgery, which is a big win for people with morbid obesity and related health issues. While insurance for obesity injections is still evolving, growing awareness and medical necessity documentation may improve chances of approval.
Shilpa Arora is co-founder & COO at Insurance Samadhan.
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