One study shows that the average time from when weight loss surgery is considered to actually having the procedure is 3 years. a lot of time can be spent studying, reading, and talking with post-op patients about their surgery.
The average cost of gastric bypass surgery is $23,000, the average cost of gastric banding is $14,500, and the average cost of sleeve gastrectomy surgery is $14,900. So before you get too involved , take time to determine if your insurance will cover weight-loss surgery.
Weight loss surgery is performed predominantly on middle to upper class patients. most people considering weight loss surgery cannot afford to pay $20,000 to lose weight. But today, more than ever, insurance companies are beginning to cover weight-loss surgery.
Should I use insurance or cash to pay for the surgery?
Insurance is often the best option when considering weight-loss surgery. however, many procedures are not covered by insurance. historically, gastric sleeves, duodenal switches, mini gastric bypasses, and other “experimental” procedures were not covered. Currently, gastric sleeves, laparoscopic gastric bypass, and laparoscopic gastric banding are typically covered by most major insurance companies. but this does not necessarily mean that your policy includes coverage.
It depends on your policy, not the insurance company.
While most insurance companies offer some form of coverage for weight loss surgery, your individual policy details what is included and what is not. some policies specifically exclude weight-loss surgery. most insurance companies charge more to include coverage for weight loss surgery. For this reason, you’ll want to check your policy to see if you have coverage. the best way to do this is to call your provider directly (the number is usually on the back of your insurance card).
You can also call a couple of local bariatric surgeons and their staff will check to see if you have coverage. use our surgeon locator to find a bariatric program in your area.
If you have coverage, then it’s time to find a surgeon. We recommend attending a couple of seminars and meeting with at least two different bariatric surgeons. this article will guide you through choosing a great bariatric surgeon.
I don’t have coverage.
You still have options. remember that it took her a long time to gain weight and she has probably been trying to lose weight for most of her life. be patient and stay focused on getting to surgery.
- before it’s time to elect your benefits for the year, call hr and ask specifically about weight loss surgery. Often the PPO plan offered includes coverage for weight loss surgery, while the HMO plan does not. And if none of the insurance plans offer weight-loss surgery, ask why. There is a great deal of evidence available showing the health benefits of weight loss surgery. undergoing surgery will not only change your life, it will make you a more productive worker!
- Consider a medical loan. Many bariatric programs work with companies that offer loans for patients who want to have bariatric surgery but don’t have insurance coverage. ask your bariatric surgeon if they work with any financial institutions to obtain loans.
- Your car probably costs more than bariatric surgery. which one will make you feel better and healthier?
- double check to make sure your state’s medicaid program covers weight loss surgery before you switch.
certain states have laws that require insurance companies to cover weight-loss surgery if the patient meets nih health criteria. and not all insurance companies will cover a full procedure. some will cover the procedure, but not anesthesia or an overnight hospital stay. while other insurance companies do not cover any type of weight loss surgery.
did you know?
Most insurance companies have some type of coverage for weight loss surgery. again, the key is to check if your policy includes coverage.
What else should I know?
- what is an accredited center?
- how do I find an accredited center?
- what is a medically supervised weight loss program?
- where can I get a letter of medical necessity?
- am I morbidly obese?
- what is a bariatric seminar?
- my insurance declined my coverage!
- how do I appeal ?
How much does weight loss surgery cost if I pay cash?
- how much does a gastric lap band cost?
- how much does a laparoscopic gastric bypass cost?
- how much does a gastric sleeve cost?
How do I get approved for bariatric surgery?
Dealing with insurance approvals and denials and appeals and denials creates a roller coaster of emotions. let the experts do their part. Your surgeon should have an in-house expert who will contact your insurance and start the approval process.
Don’t assume your work is finished after it’s been approved!
Make sure you stay on top of your duties and appointments. there will be many keep documented records of everything and see the specialist regularly.
This is also a good time to change bad habits. you are on your way to getting a procedure that will change your life. start changing your eating and exercise habits now or the change after surgery will be more difficult to achieve. remember, surgery does not guarantee success. In fact, if you don’t change your habits, even if you’ve had weight-loss surgery, you’ll fail. and the surgery is actually easier for the surgeon if he has lost some weight before the surgery. this decreases the size of your liver which makes the operation easier and decreases the risk of complications due to anesthesia.
Where do I find the coverage requirements for my policy?
Each insurance provider will require different documents and different proof. they may also require you to visit approved specialists. these can range from an approved psychotherapist to an approved cardiologist.
The best thing to do is call your insurance company or your human resources department if your insurance is provided through work. we have our own list that you can also check out.