The cost of Gastric Bypass Surgery and all other bariatric weight loss surgeries are expensive. The cost ranges from $17,000 to $35,000.
Insurance coverage for the cost gastric bypass surgery and all weight loss surgeries vary by state and insurance company.
Recently, Medicare announced that it will pay the cost of 3 types of weight loss surgeries.
Roux-en-y gastric bypass, Biliopancreatic Diversion and Laparoscopic adjustable banding. Medicare does mandate that the procedure be performed at a medical facility designated as a Center of Excellence by the American Society for Metabolic and Bariatric Surgery. Studies have shown that such centers help minimize the occurrence of death and complications after weight loss surgery.
In order for most private insurance companies to cover the cost of gastric bypass surgery you must meet certain requirements. Unfortunately meeting these requirements and obtaining insurance approval is not always easy.
Over the past few years, more and more people are wanting weight loss surgery of one kind or another. According to the ASBS 16,200 weight loss procedures were performed in 1994. Ten years later in 2004, an estimated 140,640 procedures took place. That’s more than an 800 % increase.
Here is a list of some of the requirements for insurance approval.
First of all you will need a letter of medical necessity from your bariaitric surgeon and your primary care physician.
It will need to include your weight, height and body mass index.
Generally a BMI of at least 35 is needed to have the cost of gastric bypass surgery covered by insurance. (calculate your body mass index with the link above.)
A description of any Co Morbidities related to your obesity.
Such as high blood pressure, diabetes, gastroesophageal
reflux, sleep apnea, ect…
A list of your current medications.
Any limitations your obesity may have on your daily activities.
A detailed history of previous weight loss efforts. Along with your weight history demonstrating a history of morbid obesity.
Most companies require a 6 month physician supervised diet showing monthly consults and weights.
I also included a personal letter explaining my own reasons for needing the surgery. Both physical and mental.
Most insurers also require a psychiatric evaluation.
I was fortunate, the cost of gastric bypass surgery for me was covered by my insurance company after fulfilling all the requirements as stated above. I had my surgery done at the Cleveland Clinic, a designated Center of Excellence by the American Society for Metabolic and Bariatric Surgery.
I had a wonderful, experienced surgeon and staff who took me through the entire process from beginning to end. My labs, evaluations, doctor visits and surgery were all done in one place and best of all the staff took care of handling all my insurance paperwork and the pre-certification process. Having a qualified surgeon with an experienced staff can go a long way in obtaining insurance approval!
(check out the Cleveland Clinic link above…They have lots of useful, helpful insurance information.)
Presently I am 2 ½ years after surgery and I’ve lost almost all the weight I needed to loose. Almost 100 pounds! I feel great and am living a much healthier, happier life !