Gastric bypass surgery costs and available medical insurance coverage

Expenses and Insurance Information on Gastric Bypass Surgery

Gastric Bypass Surgery is an expensive surgery. Your expenses will include not only the cost of surgery but also expenses on some of the post surgery essentials such as tightening the band and lifelong nutritional supplementation. Medical insurance does not normally cover gastric bypass surgery, or may only cover it under certain specific conditions. Different insurance policies have different perspectives on coverage for this surgery. It is crucial for you to find out if your medical insurance provider considers it to be a covered benefit under your specific circumstances.
 

Average Cost of Gastric Bypass Surgery

The average cost of gastric bypass surgery is about $20,000. It can range from anywhere between $15,000 to $50,000 depending on the surgeon, healthcare center or hospital, and its location.

Extra Post-surgery costs

Following the surgery, you will need to fill the band several times to tighten it. The cost of fills varies from doctor to doctor. On an average, the total cost on all these fills is usually anywhere between $ 1200-1800. In case your insurance is covering the surgery, it will usually cover the cost of fills as well.
Since the surgery leads to a rapid weight loss, your skin is likely to sag. If you were considering cosmetic surgery to remove unattractive skin, it would add more costs. Your other expenses will include those of lifelong nutritional supplements.  In addition, if some complications arise, you may incur significant unexpected costs that will vary depending on the seriousness of the complication.

Consensus on Insurance Coverage

In general, most medical insurance plans do not cover obesity treatment, as they do not regard obesity as an illness, although they do cover the expenses of related health problems like heart diseases and hypertension. Usually different medical insurance policies have different stances on covering the cost of Gastric Bypass Surgery.  Insurance coverage may be available for the surgery if it is considered medically compulsory and is not part of a weight-loss program.  Medical insurance is provided under different types of plans:

• Indemnity Insurance: This policy covers 80% of the cost of surgery and needs you to pay the remaining 20%. It covers gastric bypass surgery only if the surgery is medically necessary.

• Preferred Provider Organization (PPO): This policy also covers cost the surgery only if it is medically necessary. In case it covers, the providers want you to contract with the surgeon who they recommend. Often they recommend inexperienced surgeons who have lower prices.

• Managed Care Organizations: They have their own doctors to evaluate obligation of gastric surgery for you. If the surgery is indispensable, they might cover its cost but will try to contract an inexperienced and therefore cheaper surgeon.

• Medicare: They cover bariatric surgery if it is medically compulsory, disabling you from working or carrying out daily routine.

• MediCal (MediAid): They rarely cover gastric bypass surgery. However, if you are determined and are able to show obligation of surgery, you might succeed in obtaining coverage for surgery.
  
  Although you may finally succeed in the availing insurance coverage for your surgery, the process is so long and intimidating that many clients quit without getting the help they need.

How to find out if your insurance company will cover it

Visit your insurance company to find out if it covers the surgery. Alternatively, call the number behind of your card. In case it covers the surgery, get your surgeon to send your health information to the insurance company. If you meet the needed, your insurance company will send a preauthorization to the hospital staff.