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What Is Gastric Bypass Insurance?

Gastric bypass surgery will often lead to massive weight loss.
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  • Written By: Lainie Petersen
  • Edited By: Melissa Wiley
  • Last Modified Date: 02 October 2014
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Individuals who struggle with their weight may wonder if gastric bypass insurance is available to cover the costs of weight loss surgery. While there isn't really any such thing as a specific gastric bypass insurance policy, some health care plans do cover the cost of gastric bypass or other weight loss surgeries. They may, however, place significant conditions on their coverage, including requirements for documentation of previous weight loss efforts, psychological evaluations, and the medical necessity of the procedure.

Gastric bypass is a type of weight loss surgery, also known as bariatric surgery, in which the patient's stomach and small intestine are modified to reduce the amount of food that the patient can eat and calories that he can absorb at any one time. The resulting caloric deficit can lead to weight loss. As the goal of this surgery is weight loss, gastric bypass insurance coverage can be hard to come by.

Some insurance companies regard any form of treatment relating to obesity or weight loss as cosmetic and refuse to pay claims for these treatments. Other insurance companies may provide coverage for some treatments and procedures, but not for others. Gastric bypass insurance coverage may only be possible in cases where a patient is morbidly obese and has complicating health problems, such as a heart condition or severely damaged knees.

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The process for obtaining insurance coverage for a gastric bypass generally depends on the policy of a patient's insurance company. Many reputable providers of this surgery may even incorporate these requirements into their weight loss surgery program. This program may include the requirement that a patient participate in a doctor-supervised weight loss program for at least several months, as well as participating in a regular exercise program. Many insurers may also require a psychological evaluation that evaluates the patient's expectations of the surgery, the patient's ability to comply with the massive lifestyle changes that the surgery requires, as well as the patient's support system.

Since weight loss surgery is often very expensive, with costs running into the tens of thousands of dollars in the United States, the procedure may not be available to individuals whose insurance won't cover its costs. This is true even in cases where a person's obesity severely compromises that person's health. For these individuals, private financing, obtaining surgery in another country, or using savings or even retirement funds may be the only way to afford a gastric bypass procedure.

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