The cost of surgical weight loss: what to expect

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Weight loss surgery, also called bariatric or metabolic surgery, is a treatment option for obese people who have taken other measures to lose weight 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 the cost, insurance coverage, and financing plans for surgical weight loss.

Because obesity exposes people to additional health problems, many insurance companies cover bariatric surgery if you qualify. You may need to meet the National Institutes of Health (NIH) eligibility criteria for insurance coverage. Some states require insurance companies to cover bariatric surgery if you meet these health criteria.

Some insurance plans cover the full or partial cost of surgical weight loss procedures. Coverage may vary depending on your condition and the 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 provide?
  • What type of bariatric procedures does my plan cover?
  • What are the eligibility criteria for bariatric surgery?
  • What information does the company need to authorize coverage?

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

Obesity is linked to a higher cost of living, including medical expenses. 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 is certainly not cheap, it is much more expensive to not have the surgery, otherwise insurance would not pay for it. not. Insurance companies save money because patients are healthier.

Nau also notes that obesity can reduce income and productivity. “The [rate of] absenteeism associated with obesity is huge,” he says. “Obesity is a major cause of job loss and non-productivity while you are at work.

“Also, if someone has type 2 diabetes and you take 100 units of insulin and two oral medications, it can be financially devastating, depending on how much they have to pay.

“While surgery can’t cure their diabetes, switching them 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 by type of surgery. Some studies suggest that people lose 15% to 30% of their total body weight, although some is regained.

Research of 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 program recommended by your surgeon. Significant weight loss can have a positive impact on your quality of life and reduce health problems. You may feel better overall and find it easier to do certain activities.

“Over 95% of people will successfully lose at least half of their extra body weight and the majority will maintain it. However, numbers don’t necessarily define success, and most people really do,” says Nau.

“I tell my patient that we don’t define their success. It’s really about what they consider success,” he adds. “It may be about resolving a clinical condition like type 2 diabetes or high blood pressure. For others, it’s about doing something, whether it’s getting on roller coaster or boarding an airplane.

To get started with surgical weight loss, you’ll want to do some research and speak with at least two surgeons. If you can, consider attending an in-person or online seminar to learn more about the process.

Also, you will 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 the hospitals covered by your plan. You can also find out if you need a referral from your GP 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 is any doubt that this is the best weight loss option. There is no evidence to support anything else and the reality is that the majority of people don’t can’t lose weight on their own. That doesn’t mean they don’t try; it means obesity is complicated,” says Nau.

Does Medicare pay for weight loss surgery?

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

Does Medicaid cover bariatric surgery?

Yes, Medicaid covers bariatric surgery.

When is surgical weight loss medically necessary?

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

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

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

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