Can You Get Health Insurance for Weight Loss Surgery?

The term bariatric surgery is much bandied about these days, as it is an alternative for losing weight, especially after all the other options have been explored without much success such as dieting and regular exercising. However, weight loss surgeries are usually used as a last resort. A weight loss surgery is usually recommended for people who have a body mass index of 40 or higher. People who are overweight or obese may suffer from several health issues such as type 2 diabetes, hypertension, and/or sleep apnea.

The Difference Between Medical and Cosmetic Purpose

Just a few years back, bariatric surgery was considered a standard exclusion across the industry. However, with times changing, so are the change in technical advancements, bariatric surgery is now being covered by insurance companies now; especially if you are doing it as per the advice of the medical practitioner for health benefits. Cosmetic purposes may mean improving your aesthetic appearance.

Things to Keep in Mind to Avail Bariatric Surgery Insurance

To cover the expenses of your bariatric surgery in health insurance, here are things to keep in mind, you should be at least 18 years old. Your BMI should be more than or equal to 40; you may be suffering from several diseases such as heart disease, diabetes, or have a problem with your lungs. The procedures that fall under bariatric surgery include, gastric bypass, Sleeve Gastrectomy, the Roux-en-Y Gastric Bypass
Biliopancreatic Diversion with or without Duodenal Switch (BPD/DS) Gastric Bypass and Laparoscopic Gastric Banding.

Do You Need to Follow a Waiting Period for Bariatric Surgery Insurance?

Yes, when it comes to bariatric surgery for health insurance, it has a waiting period of usually 2 to 4 years. This means, if you want to cover your bariatric surgery expenses you will have to wait for 2 years starting from the time of the policy. So, it is always advisable to get benefits from the first health insurance policy itself.

Tests to Undergo Before You Get Bariatric Surgery

You need to meet some specific conditions to claim Bariatric surgery. It includes tests that are authorized by your surgeon. Before you apply for health insurance, you have to get all the tests done to get the seal of approval from the health insurance company. You also need to show clarity over your health conditions, whether you are suffering from any specific ailments such as type 2 diabetes or any cardiovascular problems.

How Much Does Bariatric Surgery Cost?

The average cost of a Bariatric Surgery differs from place to place. This cost may also vary as per different hospitals and cities. Before you opt for such a surgery, you may have to ask about how much you are expected to pay, whether there may be any unexpected financial burden that you may have to face in the near future. It is always safe to get all your queries answered before you take the big leap.

Once the doctor performs the surgery, the patient may have to follow a certain diet plan prescribed by the doctor. Certain weight-loss surgeries may inhibit the absorption of nutrients and calories; hence, to take care of oneself, the patient needs to have a proper follow-up with a qualified nutritionist to take care of all the post-surgery needs.

The Exclusions to Keep in Mind

Claims arising due to conditions that commenced just 30 days within the date of policy commencement are not covered in the case of bariatric surgery. Also, claims for pre-existing conditions are also not covered.  The only way to avoid any unnecessary problems in the future is to do proper research about the policy.

Medicare and Medi-Cal Benefits

Medicare may cover some bariatric surgical procedures if you are morbidly obese. Recently, Medicare expanded its coverage to include vertical sleeve gastrectomy. Medi-Cal can only cover the cost of surgery in certain California counties. If you have Medicare, Medi-Cal, or Medicaid coverage, read all about it to find out which specific coverage is available to you by calling up your health plan.

Conclusion

Many patients may decide to opt for cosmetic surgery after bariatric surgery to remove the excess skin. In general, insurance companies do not provide coverage for cosmetic surgeries, unless they may have to resolve medical problems, such as problems with your skin folds. Talk to your doctor and your insurer to find out exactly where you stand.