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Paying for Bariatric Surgery

Most patients are concerned about the costs of bariatric surgery. After all, bariatric surgery is not an inexpensive option for weight loss. Depending on the procedure, the cost can range from several thousand dollars for a gastric band or plication to over $20,000 for a gastric bypass. It is important to remember that bariatric surgery is an involved process. There will be several weeks or months of pre-operative preparations including diagnostic testing and consultations. The cost will also cover the surgeon’s fee and the hospital stay. Finally, post-operative care is an ongoing process requiring significant follow-up and support.

While the costs of bariatric surgery may seem daunting, they should be compared to the often significant costs associated with obesity. The most tangible of these come in the form of additional doctor visits, medication including those for high blood pressure, high cholesterol and other comorbidities as well as food. Intangible costs can include quality of life issues stemming from missed opportunities and compromised mobility and even the unfair, but ever-present social and professional stigma associated those suffering from excess weight. An interesting research piece from Gearge Washington University Hospital puts the cost of obesity in perspective: Click here for more

Many patients will qualify for one of three typical payment options for bariatric surgery

Insurance

Many private insurers cover bariatric surgery. However, it is important to note that different policies under the insurer’s umbrella may or may not have bariatric surgery exclusions. As a result, it is important to communicate with your insurance company and our billing department to fully understand what your policy entails.

Further, each insurance company will have their own set of qualifying criteria. Some may require documented proof of failed diet and exercise programs, while others may require the completion of physician supervised medical weight loss program. No matter what the requirements, they should be confirmed and completed in order to expedite the journey to surgery.

We will be happy to assist you with a pre-authorization for coverage, so feel free to lean on us for advice. Learn more about insurance for bariatric surgery

Insurance – Medicare Caveat

Medicare covers bariatric surgery for qualifying patients however their system is starkly different to that of most private insurance companies. Medicare does not allow for the pre-authorization of coverage meaning that your application must be submitted correctly to receive coverage. While there is an appeals process for denied coverage, it is always better to get it right the first time around, so please spend extra time ensuring all requirements have been met.

Financing

Prosper-LendingPatients who do not have appropriate insurance coverage, may benefit from the many financing options available to them. There are many third party financing companies that provide loan programs for bariatric surgery patients. Some patients may also choose to employ family members or utilize existing or new credit cards and loans to pay for their procedure. No matter what financing option is ultimately chosen, it is important for patients to remember that there are consequences for late or nonpayment, which should be considered carefully before agreeing to anything. We encourage you to speak to our billing department to learn more about possible financing options.

Self-pay patients

Patients who wish to pay for their bariatric surgical procedure in one lump sum are considered self-pay. Self-pay patients may be able to negotiate a package price with the hospital and surgeon that is somewhat more affordable than generally published pricing. It is important that all cash pay patients speak to our billing department to ensure that they understand the scope of the financial commitment they are about to make and that they have budgeted for all of the costs of surgery including pre- and post-operative care.

For those that are not financially suited to bariatric surgery, there is the lower cost option of medically supervised weight loss – a structured and effective diet and exercise program that not only assists with weight loss, but teaches the principles of how to keep it off.

No matter what form of payment is ultimately chosen, our billing specialists are happy to evaluate your options and assist you in choosing the best payment arrangement for your particular circumstance. Please call our office for more information.