Weight Loss Surgery Insurance and Costs

Insurance coverage for bariatric weight loss surgery varies by insurance company and state. If you are thinking about having this type of surgery, it is important to work with your doctor and insurance carrier to see what is or is not covered. Before the majority of insurance carriers consent to pay for these procedures, patients must meet certain thresholds and must be ready to go through the approval process, which can take a long time. In order to be approved for insurance coverage, most companies suggest that the individual keep detailed records and send copies of everything to their insurer.

Being overweight is a costly health problem. Individuals who are overweight develop various other health related diseases including arthritis, high blood pressure, strokes, heart disease, respiratory problems, sleep apnea and diabetes. The numbers show that morbidly obese people and insurance companies spend over $238 billion dollars treating weight related health issues. In addition, obese individuals are more likely to suffer an early death than people who are of normal weight. Health insurers are seeing evidence that the amount of money spent on these illnesses not only covers, but also exceeds the costs of bariatric surgery. So, approving these types of surgeries helps both the patient and the insurer save a lot of money over a period of time.

The first step in getting approved for bariatric weight loss surgery is to make sure you meet the National Institutes of Health standards. These generally state that individuals must be morbidly obese before qualifying for surgery. This means that patients should be 100 pounds or more overweight or twice their body mass index or BMI rating. Sometimes insurers will allow these types of operations on patients who weight less than 100 pounds, if that person is suffering from a disease or illness that is directly associated to being overweight.

Individuals considering bariatric weight loss surgery should completely understand their insurance carrier's policies concerning these types of operations. If you contact your insurance carrier to ask questions, be sure to document all forms of correspondence. Moreover, before seeing a weight loss surgeon, it is always a smart idea to get a referral from your primary care physician and make sure you have their approval for the procedure. Insurers are more likely to approve an operation when they know more than one physician feels the surgery is necessary.

As a matter of fact, most insurance companies demand a second opinion for any type of invasive surgery, before they agree to cover the cost. Since weight loss surgery is considered an elective surgery, they figure you have plenty of time to satisfy their requirements.

It is also recommended that a bariatric weight loss surgery patient have very detailed records of everything related to their weight associated issues. This includes records of nutritionist approved weight loss programs or participation in programs such as Weight Watchers, a membership at a diet center, receipts for exercise equipment, or fitness club memberships.