How Do I Know If My Insurance Covers Bariatric Surgery?

How much is bariatric surgery 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 is the minimum weight for gastric sleeve?

Generally, gastric sleeve surgery is indicated for morbidly obese adults — that is, people between 18 and 65 with a body mass index (BMI) of 40 or higher. For a person standing 5-foot-9, that equates to a body weight of 270. People with a body-mass index of 35 — 235 pounds for a 5-foot-9-inch adult — can also qualify.

What insurance pays for 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.

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 if my insurance doesn’t cover bariatric surgery?

If your employer-provided insurance plan doesn’t cover bariatric surgery, you may need to do some lobbying on your behalf, either with your company’s human resources department or your union reps, Wheeler says. “If you want these benefits added, go to HR, go to your employer and advocate for yourself,” Wheeler says.

How long does gastric sleeve last?

But they concluded that sleeve gastrectomy is effective nearly 6 years after the initial operation, with nearly 60% of excessive BMI still gone and a “considerable improvement or even remission” of comorbidities.

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).

Who are the best candidates for bariatric surgery?

Who is a Good Candidate for Bariatric Surgery?BMI = 40 or BMI = 35 with obesity-related conditions such as diabetes, asthma, high blood pressure, Reflux Disease or Sleep Apnea.At least 100 pounds above estimated ideal weight.Age 18 or older.Tried non-surgical weight loss methods without success.More items…•Jul 28, 2020

How fast do you lose weight after bariatric surgery?

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. By two months, most people average a 20% loss of excess weight.

Why you should not have bariatric surgery?

Bariatric patients have more psychopathology than the general population even before surgery, and Goodpaster says they have higher rates of depression and past suicide attempts, which are a major risk factor for suicide.

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 is bariatric surgery with insurance?

The average bariatric surgery costs $17,000 to $26,000, according to the ASMBS. Mounting evidence shows that surgery for morbid obesity can be more cost-effective than treating the conditions resulting from obesity. However, even with your doctor’s recommendation, your health insurance might not pay for the surgery.

How do you get approved for gastric sleeve surgery?

Gastric Sleeve BMI Requirements Patients that are interested in a sleeve gastrectomy procedure should have a BMI of at least 40 or should have a BMI of at least 30 AND have at least one serious obesity-related, co-morbid health condition.

How can I get bariatric surgery for free?

Free Weight Loss Surgery Grant Surgery Grants help people who are unable to afford gastric bypass get the funding for all or part of bariatric surgery. There is a Free Weight Loss Surgery Grant Now Available for gastric bypass through the Weight Loss Surgery Foundation of America (WLFSA).

Do any Obamacare plans cover bariatric surgery?

Obamacare Insurance Won’t Cover Weight-Loss Surgery In Many States.

How long does it take for insurance to approve weight loss surgery?

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

What can disqualify you from bariatric surgery?

You may not be a good candidate for bariatric (weight loss) surgery if you have:ongoing drug or alcohol addiction.uncontrolled mental illness.significant eating disorder.an unwillingness to comply with the necessary guidelines following bariatric surgery.

What is my ideal weight?

Weight and height guide chartHeightWeight5ft 3″ (63″)107 to 135 lbs.141 to 163 lbs.5ft 4″ (64″)110 to 140 lbs.145 to 169 lbs.5ft 5″ (65″)114 to 144 lbs.150 to 174 lbs.5ft 6″ (66″)118 to 148 lbs.155 to 179 lbs.17 more rows