It has been said that there is an epidemic of obesity in America. It is not easy to lose weight, or to keep off the weight that has been lost. Many people are turning to bariatric surgery as a weight loss solution. The problem is that most health insurance will not cover the cost of these kinds of surgeries, or the costs of aftercare.
Bariatric surgery involves a surgery that reduces the size of the stomach. There may be an implanted medical device, (such as a band), that closes off part of the stomach. Or, the surgery may actually remove a portion of the stomach itself. The surgery could involve re-routing the small intestines into a small stomach pouch. These kinds of surgeries are generally recommended for people who are obese, and have a body mass index (BMI) of 40 or higher.
People who have bariatric surgery can lose hundreds of pounds. Often, other health problems can be improved, or completely alleviated, after a person loses a lot of weight. This includes: diabetes, hypertension (also called high blood pressure), sleep apnea, and more.
Even though it is pretty clear that bariatric surgery is something that improves people’s health, you cannot assume that your health insurance will cover all of the costs related to bariatric surgery. It is entirely possible that your insurance company will deny your claim. Some insurance companies will classify weight loss surgery as “cosmetic surgery”. They see it as something similar to nose jobs, or breast enhancement surgery. In other words, they want to view weight loss surgery as an unnecessary form of surgery that is done simply for the purpose of improving one’s appearance.
Bariatric surgery can cost anywhere from $15,000 to $30,000. Your insurance company might cover some of that cost, and leave you to cover the rest out of pocket. It’s also possible that your co-pay can go as high as $5,000. There are other expenses to think about, that your health insurance may not cover at all. Losing a lot of weight very quickly can cause a person to have loose skin. Fixing this will require cosmetic surgery, and most health insurance will not cover the costs of cosmetic surgery.
If you need an after care program, this will most likely be something that your health insurance will not cover either. It also will not cover a gym membership, which you might need to help keep your weight manageable. If you lost a considerable amount of weight, you are going to need to purchase new clothing, in your new, much smaller, size. These are some of the costs that go with weight loss surgery that you may not have accounted for. If anything goes wrong with the surgery, there will be even more expenses.
If you are considering having some form of weight loss surgery, you should first make certain that you are aware of what your health insurance will, and will not, cover the cost of. Have a talk with your insurance agent, and find out what their procedure is that determines whether or not they will approve or deny your claim for this kind of surgery.
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