How to get insurance to cover bariatric surgery?

Can I buy insurance to cover bariatric surgery?

Although you may meet standard and widely-accepted criteria for medical necessity, your insurance is not required to cover bariatric surgery. If weight loss surgery services are listed as an exclusion, your insurance will not consider you for coverage, irrespective of your BMI and comorbid conditions.

What insurance plans cover bariatric surgery?

Many PPO insurance providers are now providing coverage for Gastric Sleeve, Gastric Bypass, Distal Bypass and Lap-Band Removal. Aetna, Anthem Blue Cross Blue Shield, Cigna, Oscar, Tricare and United Health Care typically cover weight loss procedures.

How long does it take for insurance to approve bariatric surgery?

It can take two to four weeks for the insurance company to respond with a decision.

How much does bariatric surgery cost out of pocket?

The cost of weight-loss surgery depends on a number of factors, including your location, the hospital, the surgeon’s fees, and the type of procedure. According to Obesity Coverage, a bariatric surgery information site, the average cost of lap-band surgery is $14,500, while gastric bypass costs an average of $23,000.

What can I do if my insurance is denied bariatric surgery?

If your insurance company denied your initial request for bariatric surgery coverage than you or your surgeon must write and submit a proper letter of appeal to the insurance company.

What’s the cheapest weight loss surgery?

Costs for bariatric procedures in the U.S. are prohibitive for many patients. The average price for LAP-BAND® (generally the least expensive bariatric procedure) is $15,000. This surgery can run as high as $30,000, depending on where you live.

How do you know if you qualify for bariatric surgery?

You typically qualify for bariatric surgery if you have a BMI of 35-39, with specific significant health problems like Type 2 diabetes, sleep apnea or high blood pressure. A BMI of 40 or higher also is a qualifying factor.

What weight loss surgery is best?

The study found that gastric bypass appeared to be most effective for weight loss: Gastric bypass surgery resulted in an average 31 percent loss of total body weight in the first year and 25 percent of total body weight after five years.

How do I get approved for weight loss surgery?

To be eligible for weight-loss surgery, you must meet the following requirements: Have a body mass index (BMI) of 40 or higher, or have a BMI between 35 and 40 and an obesity-related condition, such as heart disease, diabetes, high blood pressure or severe sleep apnea.

How much do you have to weigh to get bariatric surgery?

To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40).

How long is recovery after bariatric surgery?

Recovery in the Hospital. Patients spend an average of two to five days in the hospital following bariatric surgery, or longer if complications develop. Patients who undergo laparoscopic bariatric surgery usually have a shorter hospital stay.

What tests are done before bariatric surgery?

Certain basic tests are done prior to bariatric surgery: a Complete Blood Count (CBC), Urinalysis, and a Chemistry Panel, which gives a readout of about 20 blood chemistry values. All patients get a chest X-ray and an electrocardiogram. Many surgeons ask for a gallbladder ultrasound to look for gallstones.

How much does it cost to get your stomach tied?

Procedures similar to stomach stapling cost around $15,000. This is unaffordable for many people unless their medical insurance covers it. Coverage varies by insurance company, but some types of bariatric surgery may be covered based on your body mass index (BMI).

Is gastric sleeve or bypass better?

We bypass 90 to 95% of the stomach.” The benefits: “Gastric bypass is a more powerful tool than sleeve gastrectomy. Patients usually lose 10 to 20 pounds more with it. Rerouting the GI tract leads to some favorable hormonal changes, so the chance for diabetes improvement is higher as well.”

How much is excess skin removal surgery?

A panniculectomy is more expensive than a tummy tuck, but it’s often covered by medical insurance. The cost can range from $8,000 to $15,000, plus anesthesia and other extras. A tummy tuck is less expensive but is not covered by insurance. This elective procedure costs on average around $6,200.

Why you should not have bariatric surgery?

For most people, the risk for bariatric surgery is low, comparable to having your gall bladder removed. In fact, it may be riskier to not have the surgery. “If you stay morbidly obese,” Torquati says, “you are much more likely to die from heart disease, diabetes, stroke and even some types of cancer.”

What medical conditions disqualify you for bariatric surgery?

BMI ≥ 40, or more than 100 pounds overweight. BMI ≥ 35 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.

How much weight do you lose the first month after gastric bypass?

The amount of weight loss will depend on the person and the procedure. But it tends to be rapid in the first few months. During the first 30 days after bariatric surgery, the average weight loss is 5 to 15 pounds per week. Men tend to lose weight at a faster pace than women.

Do you regret gastric sleeve surgery?

No regrets
Although many women reported negative thoughts and health issues after weight loss surgery, none of them said they regret undergoing the procedure.

What is cheaper gastric bypass or sleeve?

Although lap-band surgery, a form of bariatric surgery, is cheaper than both gastric surgeries, gastric bypass is traditionally cheaper than a gastric sleeve.

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