Weight loss surgery cost can be substantial. Depending on the location, the procedure, and your medical coverage, costs can even be prohibitive. Considering the effects of obesity on mental and physical health, determining the costs, your insurance coverage, and ways to overcome financial obstacles to having the procedure are well worth the efforts.
How much does weight loss surgery cost?
While weight loss costs vary, the average price is around $20,000. The price without insurance coverage will be different depending on the procedure. Deciding which procedure is best for you should be left to your medical team. The decision shouldn’t be made based upon pricing but what will work the best in the safest manner possible. The average cost of weight loss surgery ranges based upon the procedure, as indicated below:
- Gastric bypass – $24,000
- Gastric balloon – $8,150
- Gastric sleeve – $19,000
- Lap band – $15,140
How can weight loss surgery be made more affordable?
Being able to afford weight loss surgery requires adjustments to the cost and payment portions of the equation. Individual cases depend on many variables – from coverage status to credit score. Cheap weight loss surgery might be achieved by travel or negotiation with the facility. Whether you have private insurance, Medicaid, Medicare, or no coverage at all, jumping through the hoops to achieve your weight loss surgery goals will be well worth it in the end.
How long does it take Medicaid to approve weight loss surgery?
While Medicaid does cover weight loss surgery, getting approval can be difficult. Not only do you have to qualify for Medicaid, you also have to meet specific qualifying markers. Weight loss surgery for low income patients is possible when deemed medically necessary rather than cosmetic.
For females, 13 years old and menstruating, and males, at least 15 years old, Medicaid may cover weight loss surgery for beneficiaries with a BMI of at least 35 and a corresponding major health condition.
Medicaid requires documentation of diet and exercise interventions and unsuccessful treatment of related conditions. The procedure must be completed at a facility certified by the American Society for Metabolic and Bariatric Surgery as a Bariatric Surgery of Excellence (BSCOE), by the American College of Surgeons as a level 1 bariatric surgical center, or a children’s hospital registered with the Adolescent Bariatric Surgery Program.
The amount of time it takes to get approval from Medicaid depends on you meeting the qualifications, filing the paperwork, and the speed of consideration practiced by program within your particular state.
Does Medicare cover weight loss surgery?
When bariatric procedures are considered to be needed medically, Medicare will cover the procedure. Patients with heart disease, type II diabetes, gastric reflux with aspiration, sleep apnea, high blood pressure, and many other health problems are directly connected to the scourge of obesity. Knowing your exact out of pocket is difficult; costs will fluctuate depending on whether you have the surgery as an inpatient or outpatient or whether it’s done in a hospital or an outpatient surgical center. Perform your due diligence to know how much out of pocket you’ll be facing after factoring in any additional coverage or other financial factors.
Does insurance cover weight loss surgery?
Health insurance coverage for weight loss surgery isn’t universal. Some policies cover bariatric procedures; others don’t. A lack of coverage or the denial of an insurance claim is actually the most cited reason for foregoing with weight loss surgery. Patients who are successful in their efforts to get approval usually receive three denials on average before being approved.
The best health insurance for weight loss surgery is a group health plan. Very few insurance companies offer individual plans, and getting coverage for those who are already overweight would be practically impossible.
How to get weight loss surgery approved?
Getting your bariatric procedure approved by your insurance should begin by determining whether your policy will cover it at all. Check your policy to determine whether such surgery is specifically excluded or whether it requires prior authorization.
When requesting a pre-authorization, you should anticipate a mound of paperwork to fill your to-do list. You will need to document medically supervised nutritional interventions, which insurance will probably not cover. As you will probably discover, insurance companies will place many obstacles in your way, and sometimes you might discover the coverage isn’t sufficient to cover your costs.
Weight loss surgery insurance secrets to maximize the chances that you’ll succeed include diligently completing paperwork and verifying coverage, filing appeals when denied, changing insurance providers to spouse’s if coverage is offered, consider new employment opportunities with employers who provide insurance that covers bariatric surgery, consistently contact insurance representatives, and keep very good records.
When all else fails, consider paying for the procedure out of pocket. You may be able to make payment arrangements with the facility and surgeon or even go to a different location for the cheapest weight loss surgery.
How can I pay without coverage?
Raising the funds to pay for your bariatric procedure without insurance coverage might be easier than you imagine. Surgical centers often offer payment plans because of the lack of insurance coverage, and special Health Savings Accounts allow you to save funds before taxes to maximize your savings with lower costs.
Other options to pay for this life-saving procedure include taking out a personal loan, opening a care credit account, crowd-funding online, borrowing from family members and friends, or even liquidating unnecessary assets.
The costs of bariatric surgery are often offset by the savings experienced after. Your medical costs later in life will likely be less since you won’t need the intense medical care required by the majority of morbidly obese patients as they age.
The advantages of having bariatric surgery are many. You stand to reverse medical complications, regain confidence, and enjoy your life again. No matter your financial situation, consider doing what’s necessary to have the surgery. You deserve to return to life with the ability to move comfortably, confidently buy clothing, apply for the next promotion, and pursue whatever opportunity obesity has been preventing.