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Diet and Weight Loss Weight Loss Surgery

Affording Weight Loss Surgery


Medically Reviewed On: October 03, 2006

Protecting your health is one of the most important ways to assure a good quality of life. If weight-related medical issues threaten your health, it may help to know that weight loss surgery has been shown to be safe and highly effective for the treatment of obesity. For severely overweight people, who cannot lose weight through traditional means such as dieting, weight loss surgery is a proven method of resolving or preventing chronic disease and enhancing one’s quality of life.

How to Get the Help You Need

Many health insurance plans will pay for some or all of the costs involved in weight loss surgery. They do this because weight loss, no matter how it is achieved, has been shown to substantially reduce a person’s overall health care usage and expenses. When a person loses a significant amount of weight, the risk of developing chronic and expensive-to-treat illnesses declines, which saves the patient and health care provider money in the long-term.

The first step is to talk to your health insurance plan representative. Coverage for weight loss surgery rose slightly in 2004, increasing from 23 percent of all employers to 27 percent, according to the National Survey of Employer-Sponsored Health Plans 2004 by Mercer Human Resource Consulting. Among large employers, 50 percent covered the surgery, up from 48 percent the year before. The survey also showed that large employers, who cover weight-loss surgery, are increasingly limiting eligibility to individuals who have complied with a behavior modification program.

In addition to speaking with your health care provider, surgeons who perform weight-loss surgery and their office staff can help patients explore their insurance and financing options.

Every plan is different. Yours may have a list of approved surgeons and hospitals in your area. If you want to use a surgeon who isn’t in the plan, ask about your options for out-of-plan services, and how that may affect costs.

If your plan refuses coverage, you may want to appeal the decision. Your plan representative will have all the details regarding what you need to do to make your case for funding.

If your health insurance is covered by Medicare, as with commercial plans, there are some restrictions on which facilities patients can use in addition to private or commercial health insurance policies. Still, people who are dependent on Medicare and are considering weight loss surgery are much better off than they used to be.

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