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Financing Weight Loss Surgery

Losing weight isn't easy -- and for many severely overweight people, exercise and diet simply aren't effective enough to shed significant weight. When all else has failed, many people start thinking about weight loss surgery, also called bariatric surgery.

You likely have questions about financing weight loss surgery -- the costs involved, what is covered by insurance, and how to convince your insurance to cover weight loss surgery.

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Choosing a Type of Weight Loss Surgery

Deciding to get weight loss surgery isn't easy. And after making the decision to do it, there are still many different procedures to choose from. The best one for you depends on a lot of things: your goals, your surgeon's preference, your current health, and of course, which procedures are covered by your insurance. Choosing a specific surgical approach will require a lot of thought and discussion with your doctor. But here's some basic information to get you started.

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The good news: Most insurance companies recognize that overweight and obese patients have an increased risk of serious health conditions like type 2 diabetes, high blood pressure, heart disease, high cholesterol, and sleep apnea.

In fact, there is plenty of evidence that bariatric surgery can improve or resolve up to 30 obesity-related conditions, according to the American Society for Metabolic & Bariatric Surgery (ASMBS).

If you have health insurance, it’s important to read your policy carefully and work closely with your insurer and your doctor to ensure that most of the costs of weight loss surgery are covered.

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

The Costs of Weight Loss Surgery

Weight loss surgery is expensive: The National Institute of Diabetes and Digestive and Kidney Diseases reports that the typical costs can run from $20,000 to $35,000.

The costs of weight loss surgery depend on several factors:

The type of surgery you're having
Your surgeon's fee
The hospital you choose

Weight loss surgery can be divided into two fundamental types: those that create smaller stomach size -- restricting calorie intake -- and those that cause malabsorption of food. There are a few basic types of bariatric surgery: 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 will vary based on where you live, your surgeon's expertise, and the complexity of the surgery.

Other costs may include:

Anesthesiologist's fee
Surgical assistant's fee
Operating room fees
Hospital room fees
Lab and other diagnostic fees
Device fees
Consultant fees (if necessary)
Follow-up procedures (for the gastric band)

Getting Your Insurance to Pay for Weight Loss Surgery

Most insurance companies require that you provide proof that the procedure is a medical necessity. Your surgeon can help provide your medical history and documentation of your obesity-related health problems.

In the last few years, insurance companies have also begun requiring patients to participate in a six-month Physician Supervised Diet Program before they will grant approval. (Medicare does not require this six-month program, but Medicare patients are often encouraged to participate anyway.)

Even if you have dieted for 10 years with Weight Watchers or under a doctor's supervision in another weight loss program, you must complete a Physician Supervised Diet Program. The insurance companies aren’t trying to find out if you can lose weight through dieting. They want you to demonstrate over the six months prior to surgery that you can commit to lifestyle changes you’ll need to make forever after your weight loss surgery.

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