The Cost of Weight Loss Surgery: What to Expect

Weight loss surgery, also called bariatric or metabolic surgery, is a treatment option for obese people who have taken other weight loss measures with minimal success. The procedure can help people significantly reduce their weight and improve their overall health.

The cost of bariatric surgery varies depending on the type of surgery, your insurance coverage, and the hospital where it is performed.

Read on to learn more about cost, insurance coverage, and financial plans for weight loss surgery.

Because obesity puts people at risk for additional health problems, many insurance companies cover bariatric surgery if you qualify. You may have to meet with National Institutes of Health (NIH) criteria for obtaining insurance coverage. Some states require insurance companies to cover weight loss surgery if you meet these health criteria.

Some insurance plans cover all or part of the cost of weight loss surgery. Coverage may vary depending on your condition and reason for surgery. You may be responsible for covering certain costs or a percentage of the surgery.

Questions to ask your insurance company may include:

  • What type of coverage does my current plan offer?
  • What type of bariatric procedures does my plan cover?
  • What are the eligibility criteria for weight loss surgery?
  • What information does the company require to authorize coverage?

Weight loss surgery financing plans are available. Some options include loans and payments through a third-party credit company. Some hospitals may offer bundled options if you plan to pay out of pocket.

Obesity is associated with higher costs of living, including medical costs. Obese people often spend more on medical care, drugs and insurance. Obesity is linked to several chronic health conditions, including heart disease, type 2 diabetes and high blood pressure, which can increase health care costs.

Dr. Peter Nau, a bariatric surgeon at the University of Iowa, says, “While weight loss surgery certainly isn’t cheap, it’s much more expensive not to have the surgery, otherwise insurance wouldn’t pay for it.” Insurance companies save money because patients are healthier.

Nau also notes that obesity can reduce income and productivity. “The [rate of] obesity-related absenteeism is huge,” he says. “Obesity is an important cause of job loss and lack of productivity while at work.

Also, if a person has type 2 diabetes and you’re on 100 units of insulin and two oral medications, it can be financially devastating, depending on how much they have to pay out of pocket.

“Although surgery may not cure their diabetes, going from 100 units of insulin and two oral medications to just one medication can make a huge difference in their cost,” Nau says.

Success rate of surgical weight loss vary depending on the type of surgery. some studies suggest that people lose 15% to 30% of their total body weight, although some of it is regained.

Research by 2017 suggests that people can lose 60% to 70% of their excess weight.

To maintain weight loss, you will need to adopt healthy lifestyle habits and follow the diet and exercise plan recommended by your surgeon. Major weight loss can positively impact your quality of life and reduce health concerns. You may feel better in general and find it easier to do certain activities.

“More than 95% of people will successfully lose at least half of their extra body weight, and the majority will keep it off. However, numbers don’t necessarily define success, and that really is the case for the majority of people,” Nau says.

“I tell my patient that we don’t define their success. It’s really about what they consider success,” he adds. “This may be the resolution of a medical condition such as type 2 diabetes or high blood pressure. For other people, it’s doing something, whether it’s getting on that roller coaster or getting on that plane.

To get started with weight loss surgery, you should do your research and talk to at least two surgeons. If you can, consider attending an in-person or online workshop to learn more about the process.

You will also need to see if you meet the criteria for your insurance coverage. This may include specific body mass index (BMI) and obesity-related conditions.

Check which hospitals your plan covers. You can also find out if you need a referral from your primary care physician and provide information about your medical history. You may also need to provide evidence that other weight loss methods have not been effective.

Is surgery a good option for weight loss?

“I don’t think there’s any doubt that it’s the best option for weight loss.” There is no evidence to support anything else, and the reality is that most people cannot lose weight on their own. That doesn’t mean they don’t try; that means obesity is complicated,” Nau says.

Does Medicare pay for weight loss surgery?

Medicare will cover weight loss surgery for people who meet the criteria, which include a BMI of 35, an obesity-related condition, and unsuccessful attempts to lose weight.

Does Medicaid Cover Weight Loss Surgery?

Yes, Medicaid covers weight loss surgery.

When is weight loss surgery medically necessary?

“Weight loss surgery is not medically necessary in the sense that you won’t live if you don’t have it. However, if people are struggling with obesity and related health problems and can’t manage it on their own, they should consider weight loss surgery as an option,” Nau says.

Bariatric surgery is a good weight loss option for people who meet the criteria. If you are considering weight loss surgery, there are many cost factors to consider. If you have insurance, you’ll want to find out what your plan covers and see if you’re a candidate.

To learn more, talk to at least two bariatric surgeons and attend an in-person or online seminar. With a lot of information, you will be able to make the best decision for you.

Leave a Comment