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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... Options Before Gastric Bypass If you are intending to have a gastric bypass performed there are several steps you need to go through before the surgery. First off you’ll need to do some research for yourself and decide if a gastric bypass is for you. Then you’ll need to see your doctor. Many doctors will insist on trying alternative methods of weight loss before moving on to the last resort as they call it. A gastric bypass surgery is permanent and an extreme form of weight loss. There are patients who undergo the surgery only to fail to lose their weight and keep it off. This can occur from cheating, falling back on old habits or a sedentary lifestyle. So if you really want to lose the weight by having a gastric bypass done you are going to have to make lifestyle changes in addition to the gastric bypass surgery. There may be a two year period in which you work with your doctor before the surgery to make dietary and exercise changes. If you still cannot lose sufficient weight to be considered healthy then the...