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Author:
Craig Thompson

Depending on the type of major medical insurance policy you have, most insurance companies will pay for gastric bypass surgery (also called bariatric surgery) if you meet certain conditions. However, some insurance companies have exclusion clauses for treating obesity. These companies refuse to cover any treatment related to "losing weight." They will, however, treat the diseases caused by excessive body weight. How do I qualify for coverage?

To qualify for coverage, gastric bypass surgery must be considered a medical necessity. The insurance company will make the final determination. They may rely on the information your doctor sends to them or they may require you to be seen by a doctor that they specify.

In either case, certain conditions must exist. Your weight problem must present a serious risk to your life. Don't be surprised if they require a complete psychological evaluation in addition to your medical records. It is no secret that people eat too much of the wrong kinds of food for many reasons. While genetics and metabolic rate do affect how much a person weighs, often the primary causes of obesity are emotional and psychological. Gastric bypass surgery will not fix these emotional and psychological problems. In fact, if these issues are not dealt with prior to or along with the surgery, the patient may be more likely to experience serious complications. For this reason, all insurance companies require both a medical and psychological clearance before they will approve the surgery.

Remember, insurance companies are businesses. If they think you are a good candidate to maintain the weight loss permanently and that the $25,000 to $50,000 dollar price tag for gastric bypass surgery now will save them money in the long run by eliminating payment for other weight related medical problems, they will most likely cover the surgery.

How much will my insurance carrier cover?

If you are approved for gastric bypass surgery, your insurance company will pay anywhere from 50 to 100 percent of the hospital and doctor fees. Some policies will even cover in-home nursing care after release from the hospital if it is deemed necessary by the doctors and approved by the insurance company.

Several different expenses typically are associated with gastric bypass surgery, such as testing to determine eligibility for gastric bypass surgery, pre-admission testing, in-hospital costs, surgeon and other doctor fees, and post-surgery medication and care. Even if your insurance company will not cover the actual procedure, they may cover one or more of the other costs related to your gastric bypass surgery.

How can I make up the difference?

Your surgical center should be able to help you determine what will and will not be covered by your specific policy. In addition, many surgical centers offer low-interest, long-term loans if you are not approved by the insurance company, do not have medical insurance, or have high co-payments.

Since 2000, the total cost of all medically necessary weight loss treatment has been considered a deductible medical expense for income tax purposes. Those tax deductions can help you pay for at least part of the cost of your gastric bypass surgery or help you get back your co-payment for the surgery. Under the Internal Revenue code, treatment for weight loss includes behavioral counseling, nutritional counseling, prescriptions, and gastric bypass surgery if they are undertaken to treat or prevent specific diseases caused by excessive body weight.

This article provides an overview of health issues related to gastric bypass surgery and is not intended to replace the advice of a medical practitioner. Please consult your doctor prior to making any major medical decisions.

About the author:

Craig Thompson, better known as "Big T," a former sumo wrestler who used to tip the scales at 400 pounds has since reinvented himself as a singer and bandleader. As one of the earliest to have Gastric Bypass Surgery, in 1997.

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A Quick Note From The Publisher... If you like the article above, you may be interested in the following article which is also related to Gastric Bypass... Gastric Bypass Surgery - Types And Risks Gastric bypass surgery is a common form of weight loss surgery that results in outstanding weight loss with minimal side effects. But once you undergo the gastric bypass surgery procedure you have to accept lifelong changes in your diet. The post-diet of gastric bypass surgery includes an adequate intake of protein, taking vitamin and mineral supplements including multivitamin, iron and calcium, B12 and avoiding sweets and fatty foods. Types of gastric bypass surgery In gastric bypass surgery, the surgeon takes off a large portion of the stomach leaving behind a tiny pouch. It is this small pouch that prevents overdose of eating as it can take very less amount of food. Moreover, with large parts of your stomach and small intestine bypassed, most of the nutrients and calories in the food do not get absorbed at all. This helps the person from gaining excess weight. There are several types of bypass surgery operations. They are: §Roux-en-Y gastric bypass [RGB] – this is a common...