According to the CDC, over a third of adults in America suffer from obesity. That amounts to nearly 80 million people. We can blame it on largely sedentary lifestyles, the ready availability of food, or a reliance on fast food and processed items that contain massive portions of fats, sugars, and chemical additives; but the truth is that there could be any number of contributing factors involved in the obesity epidemic.
The more important question is how to address obesity. Being overweight can lead to all kinds of health issues, from aches and pains to serious concerns like diabetes, heart disease, and other potentially life-threatening conditions.
How can obesity be treated? Ideally, diet and exercise can be employed to lose weight, but for those who are severely overweight, more immediate steps may need to be taken. Gastric bypass, which involves sectioning off a small portion of the stomach to reduce the amount of food a person can ingest, can help those who are obese to lose weight faster than the average diet and exercise regimen alone.
However, the procedure isn’t cheap. The average price tag for this procedure could come in at over $20,000, and that’s if there are no complications following surgery. In other words, most people wouldn’t be able to afford gastric bypass without the assistance of insurance coverage.
Will your health insurance cover gastric bypass surgery? Here’s what you need to know before you schedule your surgery.
Coverage of certain surgical procedures may depend on the insurance provider you have. Different providers have different requirements and coverage options for this surgery.
Some policies require that patients are over a certain age, that they exceed a certain BMI (body mass index), and/or that they have additional risk factors associated with obesity, such as sleep apnea, high blood pressure, diabetes, or heart disease, just for example, before they are eligible for gastric bypass surgery coverage. In some cases, coverage requires that patients also participate in diet and exercise programs supervised by a physician.
It will, however, depend largely on the insurance provider you choose. If you’re interested in gastric bypass surgery, it pays to take your time comparison shopping to ensure that your provider offers such coverage and that you meet the criteria to qualify.
Even if your insurance provider offers coverage for gastric bypass surgery, the policy you choose could determine how much coverage you receive. You need to carefully consider plans, deductibles, co-pays, and so on to make sure you receive the most coverage for your procedure. Don’t forget, you could also use supplemental policies to help cover additional out-of-pocket expenses.
Gastric Bypass Coverage under Obamacare
What if you apply for insurance coverage through Obamacare? What if you receive assistance or you have Medicare or Medicaid? Do these health insurance policies cover gastric bypass?
Gastric bypass surgery may fall under the category of essential health coverage, but not necessarily in every state. Under the Affordable Care Act (ACA), or Obamacare, all states must provide coverage for obesity screening and counseling services. However, if you have health insurance through Obamacare, you’ll need to check with your state to see if your gastric bypass surgery is also covered.