Does Medicaid or Medicare cover weight loss surgery?
Check if your insurance company or Medicare insurance covers weight loss surgery – and which procedures are covered.
Bariatric surgery is one of the most popular methods for managing weight loss for individuals that are considered obese. It is a last resort effort for people that have tried other monitored or guided weight loss efforts and had no or minimal success. One concern that most patients have is the cost of bariatric surgery. The costs related to these types of operations vary greatly from surgery to surgery as well as location. Also, the prices could be different depending on the patient and the type of services that they expect.
The average price for bariatric surgery runs from $15,000 to $36,000 depending on the operation type, the location of the professional and the professional themselves. The three most popular types of bariatric surgery include Lap-Band surgery, gastric sleeve surgery, and gastric bypass. These three operations require a different amount of surgical technique.
Lap-Band surgery is the least invasive of the bariatric surgeries. The process includes placing a band around the stomach to make it smaller. This is usually accomplished with the use of a laparoscope and requires no open surgery. This translates into lower costs and less recovery time. Although some surgeons will charge more or less, the average price range for this surgery is between $9,500 and $24,000. This number may or may not include follow-up visits or possible medications for the patient. The cost is different from city to city such as New York City with an average price of $22,000 and Las Vegas the average is $11,000.
Gastric Sleeve Surgery
Gastric sleeve surgery is more complicated than the Lap-Band surgery but does not require the same open surgery that most gastric bypasses do. Instead, the gastric sleeve surgery is usually laparoscopic in nature requiring only a couple of small incisions used to insert a tool for the work. The stomach is reduced in size by about 85% leaving behind a sleeve-like shaped stomach. This reduces the amount of food that can be put into the stomach. The cost associated with gastric sleeve surgery is a little more than that of Lap-Band surgery due to the involved nature of the operation. Average expenses of the surgery range from $12,500 to $24,000. This may be different in different cities, for example in Boston the average price of the surgery is $35,000 and in San Antonio, it is $13,500.
Gastric Bypass Surgery
Gastric bypass surgery is the most invasive of the three traditional weight loss surgeries and is somewhat more expensive. Also, there is a longer recovery time due to the open nature of the operation. The surgery requires that the surgeon reduces the size of the stomach substantially creating a small pocket at the top of the stomach. After this is completed, the surgeon will create a new connection between the small pouch created and the lowest point in the lower intestine. This is the new route for the food to travel ensuring that it misses most of the digestive process. This means fewer calories and nutrients are absorbed by the body, and less food can be taken into the smaller stomach. The average cost of this surgery runs from $15,000 to $35,000 depending on the location, the surgeon, and the patient’s overall condition and needs throughout the procedure and the recovery. For example, in New York City the average cost of this surgery is $35,000 while in Atlanta it is $19,900.
Included in the Cost
When you are considering the costs of the various bariatric surgeries, you will need to remember what is include in the price. They typically include pre-operative consultations, the hospital fees for the procedure and the stay during recovery, medications, anesthesia, the professionals doing the work and any medications. It could also include lab work and x-rays.
There are other costs that may or may not be included in the expense of the surgery. Some of these might include consultation with a nutritionist and an expert in exercise, follow-up appointments, and additional medications. For the operation to be effective, it is often necessary for the patient to make significant life changes such as diet and exercise. These things can come with a price that is not a part of the surgery costs.
Medical tourism, the act of traveling abroad for affordable healthcare. Medical tourism has exploded in the most recent history, especially for weight loss surgery. Individuals who lack insurance, who are underinsured, or who face high deductibles, can save thousands by opting for medical tourism.
The leading destination for medical tourism is Mexico, with dozens of companies selling affordable self-pay options. Undergoing weight loss surgery in Mexico can save individuals 70% of the self-pay prices.
Regardless of the type of surgery that you and your physician decide is the best for you, the cost will need to be paid in some way. There are several options for paying for the surgery depending on the facility and your situation. Most facilities will provide you with a fairly substantial discount if you can pay for the surgery at the time in cash. This is an excellent way to save on the overall price of the procedure.
In some cases, you will find that your health insurance provider will pay a portion or all of the costs for the various types of surgery. They may pay 85% and leave you with a small amount to pay out of pocket. This can provide you with reliable options and will depend on a great deal on the requirements for coverage according to the insurance plan. It could be beneficial to check with them regarding coverage before you discuss the options with your physician.
Another option for paying for the bariatric surgery you choose is to set up a financing plan for the facility. Some institutions will offer you credit if you fit the criteria. They might also offer you a payment plan that you can handle on a monthly basis. This ultimately depends on the facility and your financial situation at the time of the surgery.