Your guide to surgical weight loss and how to pay for it
January 5, 2012 Top Health NewsSurgical weight loss is not a decision solely made on health issues or emotional needs, although this is a very large part of it. Another key component on deciding whether to undergo surgery for weight loss is cost, and how to pay for it. Just like any other major surgery, the costs can be incredibly expensive, both short-term and long-term. Whether this surgery for weight loss is for you, or a family member that is a dependent under your insurance policy, you need to understand all the facts and costs around this procedure to determine if this is something you can do right now, or need to wait a couple years.
Total costs: According to reports, bariatric surgery can cost anywhere between the range of $17,000 to $30,000. This includes (but is not limited to) surgeon fees, hospital fees, and anesthesia costs. Of course, this is just an estimate and is completely dependent on the hospital and surgical weight loss program you choose. Different weight surgery procedures, like gastric bypass surgery, adjustable gastric band surgery, and the newer sleeve gastrectomy will all have different price points since they will differ in terms of procedure complexity, hospital stay, and required follow up care. Before you even think about your insurance policy, you need to work directly with the hospital to understand exactly what is best for you (taking into account your BMI, previous health history, weight goals), and the complete details around this procedure, such as how long you will need to be in the hospital.
Insurance coverage: Depending on your weight and situation, insurance companies may cover a large portion of your surgery for weight loss. Again, this is completely based on your personal insurance carrier and policy. Hospitals like Eastern Maine Medical Center (EMMC) located in Bangor, Maine and known for its Surgical Weight Loss program, recommend that individuals contact his/her insurance provider directly to not only ensure weight surgery is a covered benefit under the plan, but also to understand if there is any specific criteria that you (or your surgical weight loss program) must meet before you are qualified under your plan policy. Once you have a clear idea of your insurance coverage in relation to your weight surgery, get this in writing and have it sent to you and your surgical weight loss provider. Once your hospital has this authorization and details, there will be a much clearer understanding if out-of-pocket expenses exist.
Additional costs: If you are required to pay fees outside of insurance coverage, discuss payment options with the surgical weight loss provider. Understand if this money needs to be paid upfront, or if a recurring payment plan is available to patients.
Time off from work: Depending on the weight surgery you choose, you will need to take a certain amount of time off from work. Work closely with your employer to understand how this will be allocated across paid vacation time, time earned, and unpaid time. It is incredibly important you are upfront with your employer about the total amount of time you will need, and do not automatically say the lower side of the estimate your doctor gave you. It is worse to request the time or delay your return to work after the fact, so give your employer the ability to plan ahead.