Bariatric surgery cost differs for a number of reasons. However, as of 2010, several insurers have begun to cover large portions of bariatric surgical fees. Depending on the weight loss procedure, costs will differ. Many gastric sleeve and bypass surgeries cost higher than band processes, resulting in less insurance coverage. One must consult with his or her insurance provider in order to definitively know the coverage available.
Bariatric Surgery Costs
Many bariatric surgeries fall between $15,000 and $30,000. Multiple types of these weight loss surgeries have developed in order to serve patients with the proper treatment. This range of procedures has also caused a variety of costs and finance standards as well.
Nearly all bariatric surgeries involve a number of fees. These specific costs include pre-procedural tests, X-ray charges, a surgeon's fee, a standard hospital fee and the cost of anesthetics. Since some procedures such as the gastric bypass surgery require longer hospital downtime, processes like this one tend to remain higher than others.
Insurance Coverage
Not every insurer covers bariatric surgery costs, although several do cover portions of the overall cost. Many states within the US do offer full coverage to patients seeking bariatric surgery. Others simply pay a portion of the costs, like independent insurance companies and groups.
Medicare Coverage
Another financing option helps patients pay virtually no money at all for bariatric surgery. Part of a bill passed by the US Congress specified that a few bariatric surgery options will remain free to patients over the age of 65.
Two of the processes covered on this plan allow food to bypass most of the stomach, causing much less weight gain in patients. The other process covered in full by Medicare uses gastric banding to pinch off a portion of the stomach.
Many requirements do stand intact for patients eligible to undergo such procedures. Most of these specific requirements change from state to state and city to city as well.
- A patient must have a BMI of at least 35.
- The patient must have an identifiable health issue that relates to obesity. These include diabetes, abnormally high blood pressure and heart disease.
- The center or hospital administering the surgery must receive approval from the American Society for Metabolic and Bariatric Surgery.
When Medicare grants a certain site the approval to perform bariatric surgery through its coverage system, the action helps ensure safety. The administering group must meet a certain set of requirements, including prior experience with bariatric surgeries with limited faults and safety concerns.
Medicaid
The Federal Government covers some bariatric surgery costs for individuals who have a very low income. This coverage differs between each state, meaning some Medicaid receivers do get government based coverage while others do not.
Insurance Company Coverage
Unlike bariatric surgery covered by the government, private insurance groups often require a wide variety of information in order to grant full or partial coverage. Patients must often provide all medical records pertaining to their weight loss or weight gain problem. These individuals usually have to give other detailed information including BMI, medical concerns and a full plan for pre- and post-surgery.
