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One of the most popular weight loss surgeries is the gastric bypass. This procedure involves adjusting the size of the stomach and then cutting the small intestine and attaching one of the open ends to the newly formed stomach pouch.
This entire process causes food to pass directly through the stomach into the second part of the small intestine, bypassing the first section. Reducing the amount of food consumed and the amount of nutrients absorbed into the system leads to weight loss.
Gastric bypass is beneficial for people diagnosed with obesity or even those who may have a lower BMI (body mass index) but have obesity-related conditions such as diabetes and high blood pressure.
It can be expensive, ranging from $20,000 to $25,000. Paying the bill in person can be difficult and can take a huge toll on your pocketbook and budget. Whether your insurance provider will cover the weight loss procedure will depend on the insurance plan you signed up for and the benefits it offers.
Some insurance providers will not cover weight loss surgery or any costs related to preparation before surgery or care needed after surgery. Check with your insurer ahead of time to see if it will cover any part of your gastric bypass surgery.
Some insurance providers that do cover weight loss-related procedures often have requirements that must be followed up front before spending is approved. These include:
• Proof that you followed a diet medically supervised by a doctor for approximately three to six months.
• Proof that you consulted a dietician which led to the introduction of a low calorie diet.
• Behavioral changes are being made to adapt to a new lifestyle that would facilitate weight loss.
• A medical record that has proof of increased physical activity on your part.
The insurer can still decide not to cover the costs of your procedure, but many times you can file an appeal 30 to 60 days after their decision. Take advantage of the appeal period because, based on the information provided in your appeal, the decision to cover your gastric bypass surgery may be upheld.
If you ultimately can’t get your insurance provider to cover the surgery, you may want to explore other options for financing the surgery. There are financial service providers that offer loans to cover these procedures, of course they charge interest, so take a good look at the rates before accepting an offer. These loans can be paid back over several years.
Many weight loss surgery clinics provide patient advocates who will work with your insurance provider and file any necessary paperwork on your behalf. They will discuss all of your options to help you get the financing you need to have weight loss surgery to start a healthier, happier life.