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You are here: Home / Financial Wellness / Health Insurance / What Health Insurance Plans Cover Bariatric Surgery?

What Health Insurance Plans Cover Bariatric Surgery?

April 7, 2022 by Janey Danes Leave a Comment

What Health Insurance Plans Cover Bariatric Surgery

The number of obese individuals is increasing every year. According to WHO, the prevalence of obesity tripled between 1975 and 2016. Unfortunately, talking about obesity is more than just talking about healthy eating and exercising. In some cases, obese individuals may need to undergo bariatric surgery. What health insurance plans cover bariatric surgery?

Let’s find out here.

See Also: Do Weight Loss Clinics Work?

What Health Insurance Plans Cover Bariatric Surgery?

Many health insurance plans cover bariatric surgery. Or you can buy bariatric surgery insurance with your provider.

But before obtaining these plans, you must know that there are conditions you need to meet.

  • 18 years old. Health insurance plans that cover this surgery will only pay for the cost of the procedure if the insured person is at least 18 years old.
  • More than 40 BMI. Or if you’re diagnosed with morbid obesity with heart disease, you can avail of a plan that covers this procedure.

Who Is Suited for Bariatric Surgery? 

Although bariatric surgery can help you lose weight, it may not be suitable for you. You may think that you’re obese but you may not be morbidly obese for your doctor to recommend such a procedure.

On the other hand, if you weigh 100 kilograms or more, then you may undergo this weight loss procedure.

If there’s a member in your family who suffers from it or you may tend to gain abnormal weight, this procedure may be suitable.

How Does Bariatric Surgery Insurance Work?

Previously, health insurance plans excluded bariatric surgery from the list of covered procedures. But with the increasing need for this procedure, this operation is now considered a covered procedure by most health insurance plans.

Thus, if you need to undergo this procedure because it’s medically necessary, your health insurance plans may cover the expenses related to it.

Then again, it is only covered if it is deemed medically necessary. Thus, if you’re going to undergo this procedure for cosmetic purposes, then your health insurance policy won’t cover it.

See Also: Can Health Insurance Plans Discriminate?

Is There a Waiting Period Before Your Plan Will Cover It? 

There is a waiting period of two to four years. It depends on your health insurance policy.

Thus, before you obtain a plan, you need to ensure that it can cover such a procedure. And if it can, you need to wait for two years before your policy can pay for the expenses related to the procedure.

What are the Documents You Need to Obtain a Plan Covering Bariatric Surgery?

You have to submit a documented detailed history of your health problems as a result of your being obese to your health insurance provider.

Furthermore, your doctor must provide a letter or note to your provider that several treatments were attempted but were unsuccessful.

Do You Need to Pay Extra to Avail this Insurance? 

In the base policy, this procedure isn’t covered. But because of the changing times, many providers now allow their clients to add this benefit to their policy. But you have to pay an extra premium for it.

See Also: How to Choose the Best Health Insurance?

Is Bariatric Surgery Dangerous?

What Health Insurance Plans Cover Bariatric Surgery -- obesity

Obesity is now considered an epidemic. Thus, more and more people are considering this procedure.

This is a serious health issue that can lead to diabetes, heart problems, and premature death.

As regards its safety, various factors can affect the outcome of this procedure. Age may be a huge factor. However, other health issues can make this surgery riskier.

People in their 60s and early 70s can still undergo this procedure with high success rates. Thus, if you’re older, you must talk to your physician to determine whether or not you’re an ideal candidate for this procedure.

Furthermore, the risk of this procedure is lower compared to gall bladder removal surgery. It’s also riskier if you don’t undergo such a procedure if your doctor has already recommended it.

Keep in mind that being morbidly obese will lead to several life-threatening conditions, such as stroke diabetes, and cancer.

The recovery time for this procedure can be brief. Some patients will only stay a night or two in the hospital. After that, they can leave the hospital. But they can only eat solid foods two weeks after having a liquid diet.

See Also: What Does Most Health Insurance Cover?

Is Bariatric Surgery the Last Option? 

In most cases, this is the last resort of so many. If you have not tried dieting or exercising, your doctor will first recommend it before suggesting this procedure.

If you’re 20 or 30 pounds overweight, you can still go on a diet and perform regular exercise. They can help you lose weight.

However, if you’re 50 or 60 pounds overweight, your attempt to lose weight with diet and exercise will fail 90% of the time.

One reason is that losing such an amount of weight and keeping it off requires a commitment to extreme diet and exercise. Unfortunately, some people can’t maintain it. Thus, doctors may recommend this surgery to achieve extreme weight loss.

However, it’s still vital to stick to a healthy diet and regular exercise after surgery. Remember that bariatric surgery is only a tool. It’s not a magic bullet. You need to eat healthy foods and carry out a regular exercise to ensure you can prevent weight gain.

After surgery, your doctor will recommend talking to a nutritionist or a psychologist to ensure that you will maintain the weight you have lost. You may also need to attend classes to help you make drastic lifestyle changes. Doing so will boost your chances of long-term success.

Can You Still Regain the Weight After the Procedure? 

In most cases, patients can keep their weight off. But you need to follow a certain diet and workout routine for you to maintain your ideal weight for the procedure.

Can You Follow a Carnivore Diet After the Surgery? 

It depends on your situation. After the surgery, you must talk to a nutritionist to help you determine the right eating plan that can assist in maintaining your weight.

You may follow a carnivore diet after the surgery. But it still depends on your doctor’s recommendation. You may also choose to have a carnivore diet before surgery. Who knows, this diet might help you lose weight.

Then again, it depends on your body. You may or may not lose weight with a carnivore diet.

See Also: Is a carnivore diet bad for Kidneys?

Summary

What health insurance plans cover bariatric surgery? Most health insurance plans will cover this procedure if it’s medically necessary. But you need to pay extra for the premium and there’s a waiting period to avail of a bariatric surgery health insurance plan.

About the author

Janey Danes Janey Danes started her career as a part-time article writer, editor and proofreader in 2008. She specializes in topics related to health, travel, technology, family, and spiritual life. Danes is a licensed medical technologist and she holds a Bachelor of Science Degree in Information Technology. She is also a contributor to Travel Philippines | Entertainment and Medical Technology Avenue. You can also find her on Google+.

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