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Will Your Health Insurance Pay For Bariatric Surgery?

Bariatric surgery, along with other weight loss procedures have become more routine and are no longer considered experimental, but does your health insurance cover the cost?

FirstQuote Health Staff
Published on
May 2, 2020
Last Updated on
May 16, 2023
Will Your Health Insurance Pay For Bariatric Surgery?

It’s estimated that more than 36% of the population is overweight, which is cause for concern. Obesity and weight issues can lead to a list of diseases and medical conditions that make life difficult, but the good news is the fitness and nutrition industries are growing. More and more Americans are looking to tackle their weight issues, and take back their lives. While a healthy mix of exercise and clean meals is the best way to get back in shape, there are also surgeries and procedures available for those who need to lose weight fast and help jumpstart a healthier lifestyle.

Bariatric surgery is a great option to lose weight. There are several procedures available, which reduce the ability to binge eat and they lessen the overall consumption. The problem is that not all health insurance companies will pay for weight loss surgery. Out of pocket, it can cost a great deal of money. What is a person to do when they need help losing weight but don’t have the money to pay?

How Much Does Bariatric Surgery Cost Without Health Insurance?

Three weight loss surgery procedures are recognized as safe and effective to lose weight; they are the Roux-en-Y anastomosis, sleeve gastrectomy, and Lap-Band®. Each surgery has advantages and disadvantages. The type of procedure selected varies significantly on a person’s health needs. For instance, someone who is 200 pounds overweight will need the Roux-en-Y to lose a significant amount of weight.

A person who is around 100 pounds overweight can benefit from a gastric sleeve. The Lap-Band® is a good option too, though it requires constant medical monitoring and refilling and lessening the amount of saline in the band.

Since the Roux-en-Y requires the most significant time under anesthesia, many doctors will forgo that option when a person has medical complications. They opt to use the gastric sleeve instead, which is a quicker surgery that requires less time sedated. These operations are not cheap.

An average cost of a Roux-en-Y is between $25,000 - $35,000. It all depends on the hospital and doctor you select. The Lap-Band® is a bit more economical procedure costing between $15,000 to $20,000. The gastric sleeve is around $19,000.

Does Health Insurance Cover Bariatric Surgery?

Most health insurance companies will cover bariatric surgery and other weight loss procedures, but that wasn't always the case. It wasn't that long ago weight loss surgeries were considered experimental, and were not covered by most policies. Now, weight loss surgeries are fairly routine and have been effective in improving overall health for participants.

However, each policy has exclusions that you want to look over before scheduling surgery. It’s best to review your coverages or call for assistance.

What can you do if you need help losing the weight, but your insurance company won’t cover you? You can pay for the surgery out of pocket or switch plans. Consequently, most people who need these operations don’t have that kind of money. Many are on disability or have health limitations that prevent them from working. There are other options.

Finding Private Health Insurance To Cover Bariatric Surgery

If you need surgery and your insurance company won’t cover it, then you can do something about it. Affordable health insurance can be obtained privately. Did you know that you can have more than one health insurance company cover you at a time? When you have two insurance policies, one becomes primary and the other secondary.

So, while one policy may not cover the weight loss surgery, the other policy will pick up the tab. Getting a few health insurance quotes will show you how affordable having additional coverage can be. It’s much cheaper to get another policy than it is to pay for the surgery out of pocket. Companies like First Quote Health, offer you coverage options that won’t break the bank.

Bariatric Surgery Coverage Requirements

Affordable health insurance policies are making bariatric surgery an option for those who never thought it could happen. Though, all companies will have some requirements. First, obesity is no longer considered a pre-existing condition, so you cannot be denied coverage.

Many insurance companies require their patients to have exhausted all other avenues before they will approve them for weight loss surgery. Things needed include seeing a dietician, having a mental evaluation, running a series of tests to ensure you are healthy enough for surgery, and a documented history of obesity. Be prepared to jump through a few hoops to get your surgery approved, even if you have adequate coverage.

Find Health Insurance Quotes For Surgery

When you are obtaining health insurance quotes and looking for affordable health insurance, make sure the policy you select is going to give you the coverage you need. There is almost always some money out of pocket, but the price is significantly lower than if you paid cash for the bariatric surgery.

Buying a policy to get the weight loss surgery is a wise decision. If you're ready to get a policy, get started today!

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