Gastric bypass surgery is sometimes paid for by insurance companies and other times the patient pays for the whole thing from their own pocket. Of course it does depend on your insurance company but the big differentiator is whether or not it is considered medically necessary. If it is medically necessary, as declared by a qualified doctor, then it is more likely that your insurance company will pay for all or a part of the gastric bypass.
In most insurance policies there is a clear list of what is an allowable operation and what is not covered, so if you do some research on what type of plan you have you should easily be able to find out. But again, either way you should call the insurance company and speak to one of their representatives because there are always exceptions. If it’s medically necessary and they don’t cover it, there might be an exception that you could take advantage of but you would only know about it if you call and ask.
Hopefully this helps…
Gastric bypass surgery is a procedure that is reserved for obese patients that is aimed to significantly reduce weight when all other supervised weight loss attempts have failed. The surgery effectively reduces the body’s natural intake of calories by physically reducing the amount of space available to store food therefore reducing caloric intake.
This happens in a couple of ways, as mentioned your stomach is actually smaller along with a satiated effect that is felt by the patient due to achieving fullness before they are used to feeling full after normal feeling. This is a psychological effect as well as a physical one.
As discussed the surgery is only right for a select few who pass the evaluation process that every gastric bypass patient is required to go through. After successfully completing the evaluation the next step is the actual surgical procedure that makes the stomach smaller. The gastric bypass surgeon makes the stomach smaller by dividing the upper section and the bottom section using staples. The top section is the only section that will be used to hold food.
After the division of the stomach the gastric bypass surgeon connects the small intestine to the upper portion of the stomach to allow proper travel. The food now travels from this top “pouch” through the new connection bypassing the lower part of the stomach and on to the rest of the small intestine.
This is the basis for a gastric bypass operation.
Well in most cases if you qualify your insurance company will pay for the gastric bypass operation due to health reasons, but there are some instances where they don’t cover the cost and in that case you would be responsible for full payment.
Full payment can be anywhere from $20,000 to $35,000 including your hospital stay and associated fees. If your insurance company is going to pay for it they will most likely require some information from you and your doctor including:
Some explanations and documents to support the fact that you have tried various supervised weight loss programs.
Consultations with qualified gastric bypass surgeons who have qualified you as a potential candidate.
A psychological evaluation attesting to the fact that you are in a stable mental state.
A waiver of legal rights indicating you know the associated risks of this type of gastric bypass surgery.
