Costs of Bariatric Surgery & Methods of Getting Financial Assistance
Bariatric surgery is a life-changing procedure for many individuals struggling with obesity, offering a pathway to significant weight loss, improved health, and enhanced quality of life. However, the decision to undergo bariatric surgery is not just a medical one; it’s a financial one too. Bariatric surgery cost can be substantial, and for many, understanding how to cover these costs is a crucial part of the decision-making process.
In this article, we’ll break down the costs associated with bariatric surgery and explore different ways you can get help paying for it.
What Are the Costs of Bariatric Surgery?
The cost of bariatric surgery can vary depending on several factors, including the type of surgery, the hospital or surgical center, your geographical location, and whether you have insurance. On average, the cost of bariatric surgery in the United States can range from $15,000 to $30,000 or more. Let’s take a look at the different types of bariatric surgery and how they impact costs.
Types of Bariatric Surgery and Their Costs
Gastric Bypass (Roux-en-Y):
This is one of the most common types of bariatric surgery, which involves creating a small pouch from the stomach and rerouting the small intestine to this pouch. This procedure typically costs between $20,000 and $25,000.
Sleeve Gastrectomy:
The sleeve gastrectomy involves removing a large portion of the stomach, leaving a small, sleeve-shaped stomach. The cost of this procedure generally falls between $15,000 and $20,000.
Adjustable Gastric Band (Lap-Band):
The gastric band involves placing an adjustable band around the stomach to create a small pouch. This procedure is usually on the lower end of the cost spectrum, ranging from $12,000 to $15,000.
Biliopancreatic Diversion with Duodenal Switch (BPD/DS):
This more complex procedure combines aspects of both gastric bypass and sleeve gastrectomy. It can cost anywhere from $25,000 to $30,000.
What’s Included in the Cost?
The cost of bariatric surgery usually includes the following:
Surgical fees: This is the fee charged by the surgeon and their team for performing the procedure.
Hospital or surgical center fees: These include the costs for anesthesia, the operating room, and post-surgery recovery.
Pre-surgery consultations and testing: Before the surgery, patients typically undergo tests and evaluations, which may include blood work, EKGs, and psychological assessments.
Post-surgery care: This includes follow-up visits, nutritional counseling, and potential complications that might arise during recovery.
Medications: Costs for pain management, antibiotics, and other medications before, during, and after surgery.
While the initial cost can seem overwhelming, many people find that bariatric surgery pays off in the long run in terms of improved health, fewer comorbidities (like diabetes and hypertension), and the ability to live a more active life.
Can Insurance Help Cover the Costs?
One of the most common ways to help cover the costs of bariatric surgery is through insurance. Many insurance providers offer coverage for bariatric surgery, but the specific details depend on your insurance plan.
Health Insurance Coverage for Bariatric Surgery
Medically Necessary: Most insurance companies will only cover bariatric surgery if it is considered medically necessary. This typically means that the surgery is needed to treat obesity-related health issues like diabetes, sleep apnea, or high blood pressure. Insurance companies may require that you meet specific criteria, such as having a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions.
Pre-Surgery Requirements: Insurance plans often have prerequisites before approving surgery, such as documenting previous attempts at weight loss through diet and exercise, completing a medically supervised weight loss program, or having a psychological evaluation.
Plan-Specific Coverage: Coverage can vary significantly between providers, and even within different plans from the same insurer. Some plans cover the full cost of surgery, while others may only cover a portion, leaving patients with substantial out-of-pocket costs.
If you have health insurance, it’s important to contact your provider to find out exactly what is covered and what steps you need to take to get approval for surgery.
Additional Ways to Help Pay for Bariatric Surgery
If insurance doesn’t cover the full cost or if you’re uninsured, there are other ways to manage the financial burden of bariatric surgery.
1. Financing Options
Many hospitals and surgical centers offer financing plans to help make bariatric surgery more affordable. These plans may allow you to spread the cost of surgery over time with monthly payments, which can make the procedure more manageable. Interest rates and terms vary, so be sure to compare different options.
2. Medical Loans
Some companies specialize in offering medical loans to cover the costs of surgery. These loans work similarly to personal loans, providing you with funds to cover the cost of bariatric surgery, which you then repay in installments.
3. Health Savings Accounts (HSAs) or Flexible Savings Accounts (FSAs)
If you have an HSA or FSA, you may be able to use the funds in these accounts to cover the costs of bariatric surgery. These accounts allow you to save money tax-free for healthcare expenses, making them a great option for covering surgery costs.
4. Crowdfunding
Some people turn to crowdfunding platforms like GoFundMe to raise money for medical procedures. If you have a strong social network, this can be a viable option to help offset costs.
5. Non-Profit Organizations and Grants
Certain non-profit organizations offer grants or financial assistance for bariatric surgery. These resources are often aimed at individuals with financial hardship who need surgery to improve their health. Researching available grants in your area may uncover financial support you weren’t aware of.
6. Negotiating with Your Provider
Some healthcare providers may be willing to negotiate the cost of surgery, especially if you are paying out of pocket. It’s worth inquiring about any discounts, payment plans, or reduced rates available.
Conclusion
Bariatric surgery can be a significant financial investment, but it’s also an investment in your health and well-being. Understanding the costs involved and exploring various payment options can help you make an informed decision about how to proceed with surgery. Whether through insurance, financing, or other assistance options, there are ways to make this life-changing procedure more affordable.
If you’re considering bariatric surgery, take the time to thoroughly research your insurance options, inquire about financing plans, and explore additional ways to get help paying for the procedure. Your health is worth the investment, and with careful planning, you can make it happen.
