Prevention and Wellness

Frequently Asked Questions: The Cost of Weight Loss Surgery

For individuals considering weight loss surgery, the cost of the procedure is often a major factor in their decision. Here are some common questions and answers that might help when making this life-changing decision.

How Much Does Weight Loss Surgery Cost?

While surgery is expensive, it may significantly improve an individual’s quality of life.  A number of our patients have found that the initial cost of surgery is off set by a reduction in the amount of money they spent on medications.  Depending on the surgery selected, the average cost for surgery can range from $16,000 to $30,000.    Often times, insurance will cover 80% or more of the cost.  Our insurance specialists will be glad to work with you to verify your insurance benefits.

Will My Insurance Cover the Cost of Weight Loss Surgery?

Insurance coverage for weight loss surgery varies widely.  The majority of insurance companies will cover surgery once the qualifying criteria have been met.  This often includes providing a weight history, a letter from your primary care physician, and a qualifying body mass index (BMI). (Find out if your BMI meets the NIH guidelines)  Some insurance companies have additional requirements which may include a pre-operative diet.  Our insurance specialists will work with you to identify what is required by your insurance company and help you navigate the steps toward surgery.

What if I have Medicare?

Medicare is currently covering several different weight loss surgery procedures when performed in a Bariatric Surgery Center of Excellence such as Miami Valley Hospital.  The procedures covered include the adjustable gastric band (Adjustable Gastric Band or Realize Band), Gastric Bypass, and the bileopancreatic diversion with a duodenal switch.

What if my Insurance does not Cover Bariatric Surgery?

Some insurances exclude bariatric surgery.  If this is your situation, you have several choices: 1) Self pay for the procedure 2) Appeal to the holder of the insurance policy for coverage, 3) Change policies during the next selection period to a plan that covers surgery for obesity.

Content Updated: November 23, 2014

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