Will Health Insurance Providers Pay for Bariatric Surgery?

People who are overweight may be considering to have some form of bariatric surgery. Usually, they do this after a range of traditional weight loss methods have proven to be unsuccessful. Although they may lose some weight through dieting and exercise, they usually put it straight back on. For people who are obese, therefore, bariatric surgery is often a last chance to make a change.

The Cost of Bariatric Surgery

The best bariatric surgery, unfortunately, isn’t cheap. Luckily, however, more and more insurance companies now offer full or partial cover for this treatment. However, they will only do this if a number of circumstances have been met. A lot of people who are overweight or close to obese will feel as if they should be given bariatric surgery, but their physician will not recommend it. This is because they know they are unlikely to be accepted unless they are at least 100 pounds overweight.

It is possible that an insurance company can offer cover if the patient’s health is at risk due to them being overweight or obese. Obesity is linked to a range of different health conditions that have a significant impact not just on the health and wellbeing of individuals, but also on the overall healthcare system, and the associated insurance. If it is found that a patient has a comorbid disorder that insurance companies will pay to treat, they may recommend bariatric surgery instead.

What Insurance Companies Cover

In a lot of cases, insurance companies cover around 80% of the cost of bariatric surgery. This means that you generally do have to find the money for the other 20%. However, this is an investment into your own health and happiness and, if your doctor recommends the surgery to you, you may want to consider it, therefore.

Do make sure that you look into the terms and conditions of your insurance company to find out whether or not you will be covered. If you feel you should receive cover but your insurance company denies you the treatment, you are able to appeal against their decision. This should be done together with your physician, who will attempt tell the insurance company that this operation is truly lifesaving. Most of the time, this will make the insurance company reverse their decision.

Insurance companies will need to look at a number of facts around your life, as they do not base the decision on you as an individual, but rather on your specific circumstances. Some of the things they will need to see include:

  • Your weight
  • Your BMI
  • Your age
  • Any comorbidity disorders you have and the type of treatment you receive for this

Unfortunately, it can be a long and difficult process to claim bariatric procedures on your insurance. However, it is a challenge worth taking. Your life will greatly improve as a result of it, and you will also greatly increase your health, your wellbeing, and your overall longevity. That, surely, is worth a few conversations with an insurance company.

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