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What are the costs and insurance coverage for bariatric surgery?
According to the National Institutes of Health, the cost of bariatric surgery varies widely, ranging from about $12,000 to $35,000 or more, depending upon factors such as:
• Type of procedure performed
• Hospital that performs the surgery
• Length of hospital stay
• Area of the country where the surgery is performed
• Occurrence of medical complications
The number of bariatric procedures performed in the United States has leveled out since 2005, after rising sharply from the early 1990s. This is possibly because of insurers' increasingly stringent qualifications for surgery. It is important for patients to speak with their health insurance providers before taking steps to undergo bariatric surgery, as not all insurers cover these procedures, particularly the Lap-Band® surgery.
Questions patients might ask include:
• Does my policy cover the treatment of severe obesity? If so, is the procedure I'm considering also covered?
• Must I be referred by a primary-care physician for bariatric surgery?
• Is the hospital that would perform the surgery covered by your insurance policy?
• What percentage of the total bill will the insurance company be responsible for, and is there a deductible I will need to pay?
Patients whose policies do not cover the surgical treatment of severe obesity have several options:
• Obtain another insurance provider that covers severe obesity treatment and the procedure you and your physician are considering.
• Continue to participate in traditional, medically supervised weight-loss programs.
• Investigate whether the hospital that would perform the procedure will do so without insurance coverage if you elect to self-pay.
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