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Paying for Weight Loss Surgery

Losing weight takes work. But when you have a lot of weight to lose, and if exercise and diet aren't enough, you may start thinking about weight loss surgery, also called bariatric surgery.

You'll probably have questions about how much it costs, what insurance covers, and how to convince your insurance to cover the bill. Here’s what you should know.

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How Much Does It Cost?

Weight loss surgery is expensive. Typical costs can run from $20,000 to $25,000, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

The price of your weight loss surgery will depend on several factors:

  • The type of surgery you're having. Types of weight loss surgery include gastric bypass, adjustable gastric banding, vertical gastric banding (also called stomach stapling), sleeve gastrectomy, and biliopancreatic diversion. Each has a different fee.
  • Your surgeon's fee. This will vary based on where you live, your surgeon's expertise, and the procedure’s complexity.
  • The hospital you choose. Costs will vary and may include the operating and hospital rooms, among other fees.

Additional costs may include:

  • Anesthesiologist's fee
  • Surgical assistant's fee
  • Device fees
  • Consultant fees (if necessary)
  • Follow-up procedures (for the gastric band)

Will Health Insurance Pay?

If you have health insurance, read your policy carefully, and work closely with your insurer and your doctor to see what's covered.

Most insurance companies recognize that people who are overweight and obese are more likely to get serious health conditions such as type 2 diabetes, high blood pressure, heart disease, high cholesterol, and sleep apnea. In fact, there’s plenty of evidence that bariatric surgery can improve or resolve up to 30 obesity-related conditions, according to the American Society for Metabolic and Bariatric Surgery.

If you don’t have health insurance, you’ll likely have to pay the entire bill yourself. Some weight loss surgery centers can help you get a loan that you can repay over a number of years.

Getting Your Insurance to Pay for Weight Loss Surgery

Most major insurance companies will require:

  • Proof that surgery is medically necessary. Your surgeon can help provide your medical history and documentation of your weight-related health problems.
  • Participation in a physician-supervised diet program. You may be required to successfully complete a 6-month weight-loss program before approval is granted. Medicare does not require this 6-month program, but you may be encouraged to participate anyway. This type of diet program involves monthly visits to your bariatric surgeon's office for 6 months. The insurance companies aren’t trying to find out if you can lose weight through dieting. In fact, most insurance companies require that the patient's weight be stable during this time -- with no up-and-down fluctuations -- or you may be denied coverage. They want you to demonstrate over the 6 months prior to surgery that you can commit to lifestyle changes you’ll need to make forever after your weight loss surgery.
  • A psychological evaluation. This is to make sure that you understand weight loss surgery and the impact it will have on your lifestyle. The psychological evaluation also checks for untreated binge eating or any other psychological issues.
  • A nutritional evaluation. You will work one-on-one with a nutritionist to outline specific dietary changes and habits that need to be changed.

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