Bariatric and gastric bypass surgeries are two popular weight loss procedures that can help individuals who struggle with obesity. These surgeries work in different ways, but they both aim to reduce the size of the stomach so patients feel fuller faster and eat less. If you’re considering either of these surgeries, one question you may have is whether insurance covers them. Let’s take a closer look at each surgery and what your insurance coverage options might be.
Are Bariatric Surgeries Covered by Insurance?
Many insurance companies do cover bariatric surgery as long as certain criteria are met. For example, most insurers require patients to have a body mass index (BMI) of 40 or higher, although some will consider covering patients with a lower BMI if they also have other health problems related to their weight, such as diabetes or sleep apnea. Additionally, many insurers require patients to participate in a medically supervised weight loss program before undergoing surgery. This helps ensure that patients have tried non-surgical methods for weight loss first.
Understanding the Risks and Benefits of Bariatric Surgery
While bariatric surgery can be an effective tool for weight loss, it does come with risks. Some potential complications include bleeding, infection, blood clots, and leaks from the staples used during the procedure. However, the benefits of successful weight loss can outweigh these risks for many people. After bariatric surgery, patients typically lose between 50% and 80% of their excess weight within the first year after surgery. They also experience improvements in conditions like type 2 diabetes, high blood pressure, and heart disease.
What is Gastric Bypass Surgery?
Gastric bypass surgery is another option for weight loss. It works by creating a small pouch at the top of the stomach that connects directly to the intestines. Food then passes through this new pathway, which reduces the amount of calories absorbed by the body. Like bariatric surgery, gastric bypass requires patients to meet specific criteria before being considered for coverage. Patients must have a BMI of 35 or higher, along with comorbidities like diabetes or sleep apnea.
Is Gastric Bypass Covered by Insurance?
In general, insurance companies are more likely to cover gastric bypass than other types of weight loss surgery because it has been shown to be highly effective at reducing weight and improving associated medical conditions. However, even if your insurer covers gastric bypass, there may still be additional costs involved, such as copays or deductibles. Be sure to check with your insurance provider ahead of time to understand exactly what expenses you will need to pay out of pocket.
Conclusion
If you’re struggling with obesity and looking into weight loss surgery, understanding your insurance coverage options is an important step. While bariatric and gastric bypass surgeries can be expensive, many insurers offer coverage for these procedures when certain criteria are met. Talk to your doctor about your individual needs and goals, and work closely with your insurance company to determine what your coverage entails.