The Price of Gastric Bypass Surgery
The price of gastric bypass surgery is a top concern for those who are candidates for the procedure. Many patients also wonder if insurance will pay for the procedure. Having medical insurance doesn't mean you won't need to pay for all or part of the procedure yourself. This article will help you learn more about how to pay for bariatric surgery.
The Price of Gastric Bypass Surgery
Will Insurance Pay It?
It is important that you review your policy or speak with your insurance company directly to determine if you are covered. Some insurance plans explicitly exclude treatment, weight loss surgery, and related care, which means that they will not cover any related charges you may incur from preparing for, having, or recovering from your .
How to Get Insurance to Pay
If you are covered by an , you will need to see your to obtain his approval before seeing a specialist like a bariatric surgeon. Once you have seen the specialist and have been approved as , you will need to begin the pre-authorization process.
The approval process for weight loss surgery can be a bit more complicated than it is for other common medical procedures. It is likely that your insurance company will requestbothyour physician and your surgeon send in something called a "letter of medical necessity" as part of the weight loss surgery pre-authorization process. Basically, your doctors will tell the insurance company how the procedure will improve your health and overall well-being.
At this point, your request for authorization will be approved, denied, or the insurance company will request additional information. Your doctors may need to follow up with phone calls, further documentation, or additional letters as requested by your insurance company.
If you are denied pre-authorization by your insurance company, you can appeal the decision. All insurance plans offer an appeals process and they are legally obligated to disclose to you your right to appeal. You are typically allowed a 30 to 60-day window from the date you were denied to appeal. The process usually begins with a letter of appeal being sent to the insurance company by you, your surgeon and your primary care provider.
Calculate the Total Price
Those whose surgery is pre-approved and covered by insurance should remember to factor in any copays or co-insurance costs that will need to be paid out-of-pocket. It's important to understand the total cost of your bypass before you make your final decision. Talk to your doctor about follow-up care, and possible post-surgery procedures (like skin tightening to fix loose skin) that you might need. These costs should be clearly specified by your health insurance policy. If not, call your provider and ask specific questions so you know how much money you need to invest.
Patients Who Pay for Gastric Bypass
If you do not have health insurance, or, your insurance does not cover weight loss surgery, you will need to cover your costs yourself. This is referred to as being a self-pay patient. Hospitals offer payment plans for some services allowing you to make payments towards some or all of your expenses rather than being charged in one lump sum. Another option is to pursue for your medical expenses, but as with any other type of personal loan, you will need to consider the finance charges (interest rate) and fees.
Total Cost of Gastric Bypass and Aftercare
If you decide to obtain financing for medical costs from a private lender, you will need to factor in all of the expenses you will be faced with when calculating the amount of financing you need. Your physician should able to provide you with details about the anticipated costs.
Typical expenses include:
- Nutritionist consultations
- The bill
- that will be needed before and after the surgery
Whether you choose private financing or a payment plan with the hospital, you will need to establish exactly what your payments will be, and if they're due bi-weekly or monthly, so you can plan your budget accordingly.
Video: Weight Loss Surgery Options - Mayo Clinic
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