Bariatric Journal

Bariatric Surgery Costs & Insurance

Cost Comparison Bariatric SurgeryDiscover various insurance guides for weight loss surgery. What are the costs of weight loss surgery if you lack insurance?

Bariatric surgery is a costly medical procedure. The cost will vary from patient to patient, depending on their surgery type, insurance coverage, and location. Discover the various average costs for bariatric procedures for 2017. Also, consider the insurance companies policies regarding bariatric procedures.

Bariatric surgery is a weight loss surgery designed to change your digestive system by limiting how much you can eat or absorb. It helps fight the problem at its core; And while this may be a SUPER effective way of losing weight, It can definitely be expensive.

The cost of bariatric surgery can vary widely based on the actual surgery you would be undergoing. Here are some of the most common types of bariatric surgery:

  • Gastric Bypass (Roux-en-Y Technique)
  • Sleeve Gastrectomy
  • Adjustable Gastric Band
  • Biliopancreatic Diversion with Duodenal Switch

So let’s take a look at these different surgeries and the cost associated with each.

Bariatric Surgery - Average Cost Infographic

Surgery Cost

Gastric Sleeve Surgery typically cost $14,500 depending on various factors. Most insurance companies will require a co-pay of at least a few thousand dollars.

Sleeve Gastrectomy, sometimes known as Gastric Sleeve Surgery is a rather new surgery compared to the others. For this technique, basically, the surgeon changes the shape of your stomach to be a vertical tube. This surgery is sometimes a precursor to the more advanced biliopancreatic diversion and duodenal switch surgery and other times it’s enough on its own to help the patient lose weight.

This type of surgery is typically cheaper than the others and ranges from $4,000 – $18,000. As for insurance deductibles, your average price would be $800 – $3,600 (If your insurance covers 80%). Otherwise, expect to pay the full price upfront.

Gastric Bypass Surgery Cost

Gastric Bypass Surgery typically cost $20,000 depending on various factors. All insurance companies, offering bariatric coverage, will cover gastric bypass surgery.

A common bariatric surgery is Gastric Bypass. With this technique, surgeons basically bypass a majority of the stomach, causing your normal food capacity (about 3 pints) to be reduced to about one ounce. Typically this type of surgery is not reversible.

So what exactly are we looking at cost wise?

Well, typically this type of surgery ranges from $15,000 – $25,000 depending on your area and surgeon. Now, if you’re paying without insurance, expect to pay the full price upfront; Otherwise, most insurance deductibles come in at 20%, which would be $3,000 – $5,000 upfront.

Duodenal Switch Cost

Duodenal Switch typically cost $28,000 depending on various factors. Some insurance companies, offering bariatric coverage, will cover duodenal switch.

This is one of the most complex procedures in the field of bariatric surgery, in which 80% of the stomach is removed. It basically bypasses a majority of the intestines and stomach, which lowers both the amount you can eat and absorb.

This makes it one of the most effective, but risky surgeries when it comes to gastric bypass surgery.

This surgery typically costs in the range of $20,000 – $30,000. As usual, if your insurance covers the cost, you can expect a typical out of pocket payment of $4,000 – $6,000.

Adjustable Gastric Banding Costs

This surgery consists of inserting an inflatable band around the stomach. The surgeon can then inflate that band, which acts to constrict the stomach, lowering the amount of food you can ingest and absorb.

This is one of the most common types of bariatric surgeries, because of its relative simplicity. However, this may lead to a less restricted stomach which can cause less weight loss for some patients.

This type of surgery typically costs in the range of $10,000 – $20,000. With a 20% deductible on average from insurance, you can typically expect the out of pocket to be $2,000 – $4,000.

Bariatric Coverage by Insurance Firm

Does your insurance company cover bariatric surgery? Discover by insurance company below:

Guides to Know:

Which Procedures Are Coverage By Insurance

  • Gastric Sleeve Surgery
  • Gastric Bypass Surgery
  • Some Coverage: Vertical banded gastroplasty
  • Duodenal Switch
  • Gastric Banding Surgery

Post-Op Costs of Bariatric Surgery

As with most surgeries, there can be complications or management required after the initial surgery. Because of this, it’s good to look into the potential extra costs of surgeries like the ones described above.

In a study appearing in JAMA Surgery the average 6 month post op cost of bariatric surgery is around $7,418.

This cost is mostly incurred by follow up procedures to adjust or fix problems that occur after the surgery has taken place. Some surgeries are unsuccessful for weight loss reduction in some patients, and this cost takes into account revisions of some of the surgeries to further help induce weight loss.

The Use Of Health Insurance for Bariatric Surgery

With the high costs associated with Bariatric Surgery, it may lead to the question of using health insurance to cover the cost; Either partially or completely.

While this will change based on each individual health insurance company and coverage, there are usually base requirements to qualify for insured coverage of the procedures.

Most insurance companies may require:

  • Proof that the surgery is medically necessary
  • Previous participation in physician-supervised diet & weight loss programs
  • A psychological & nutritional evaluation

If you meet the above requirements, the surgeon can provide your insurance company with a pre-authorization document outlining the necessity of the surgery. Once done, it’s up to the insurance company to review the case and decide the next steps, whether that be to cover the cost of the surgery, or provide other solutions.

Financing Bariatric Surgery

If your health insurance doesn’t cover the surgery, or only partially covers it, there may be other options. It’s a very good idea to look at all your available options to pay for high cost surgeries such as gastric bypass. So here are some of the options you can use to finance the surgeries:

Financing Plan (From surgeon or hospital)

Many surgeons and doctors have available financing plans for bariatric surgeries.

When considering using a financed plan for the cost of the surgeries, make sure to be diligent about the terms. Some financing plans will have extremely high interest rates, which can make the low upfront cost enticing, but cause financial devastation the following months after surgery.

That being said, If you’re diligent you can most likely find a suitable financial plan to cover the costs of the surgery and the following medical costs.

Secured Medical Loan

Most banks and loan offices have special loans called “secured medical loans”, specifically designed for high cost medical procedures. This can definitely be a viable option for those who are looking to cover the high upfront cost of bariatric surgery, but don’t want to be on an aggressive hospital payment plan.

401k Loan

If you have saved up money in your retirement account, it could be possible to pull a loan from the account. While this is a relatively risky play in the long term, it’s much safer due to not owing anyone besides yourself money.

HSA (Health Savings Account)

If you have high deductible health insurance, you may have an HSA account. These accounts are paid into pre-tax and can be used for medical costs.

This is a GREAT option if you have it, and will allow you to pay for the surgery without a lot of the overhead cost of out of pocket payments or loans.

Bariatric Surgery Payment Options

Overall Cost

Wrapping up all the information above, it can be quite daunting looking at the numbers. Taking all the associated costs of bariatric surgery, with post-op and pre-op costs included, the average estimations can range from $7,500 – $45,000. While that is quite a large range, it’s often dependent on the type of bariatric surgery received and the success of that surgery for weight loss.

It’s a very good idea to figure out which surgery would be the best fit for you, and discuss the options with your physician. The prices and estimations above can also change based on your location, so it’s a good idea to ask your doctor for further clarification of the associated costs of bariatric surgery.

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