Gastric bypass surgery involves much more than merely the operation itself. In the majority of cases it will also involve extensive pre-operative counseling and many surgical centers require you to undertake a pre-treatment program before approving your surgery. Additionally, most patients will require a period of follow-up nutritional and dietary counseling. These two items can add to the final cost of gastric bypass surgery.

You also need to consider the risk of complications arising, which may require additional surgery and hospitalization or outpatient treatment. Some gastric bypass surgery patients may experience complications which will vary from minor problems which are easily treated to complications which could result in further hospitalization and possibly add to the cost.

Finally, you need to consider is whether or not your insurer will meet your costs. A growing number of insurance companies are covering weight loss surgery today but there are still all too many policies which exclude obesity treatment. Further, where a policy does cover obesity treatment, you may find that there a number of conditions detailing exactly what they will and what will not pay for. Your policy might for example limit cover to certain types of surgery (like the Roux en Y procedure) and only cover the cost of the operation itself.

Gastric Bypass and Health Insurance

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), gastric bypass surgery costs between $20,000 to $25,000 on average. Whether or not the procedure and related costs are covered by health insurance depends on your insurance company, your state, and your specific policy, among other factors.

Pre-authorization Process

If you are covered by an HMO, you will need to see your primary care physician to obtain his approval before seeing a specialist like a bariatric surgeon (a specialist who performs weight loss surgery). Once you have seen the specialist and have been deemed a candidate for weight loss surgery, you will need to begin the pre-authorization process.

The approval process for weight loss surgery can be a bit more complicated than it is for other common medical procedures. It is likely that your insurance company will request both your physician and your surgeon send in something called a "letter of medical necessity" as part of the weight loss surgery pre-authorization process. Basically, your doctors will relate to the insurance company how having the procedure will improve your health and overall well-being.

Appeals

If you are denied pre-authorization by your insurance company, you can appeal the decision. All insurance plans offer an appeals process and they are legally obligated to disclose to you your right to appeal. You are typically allowed a 30 to 60 day window from the date you were denied to appeal. The process usually begins with a letter of appeal being sent in to the insurance company by you, your surgeon and your primary care provider.

Self-Pay Patients

If you do not have gastric bypass insurance, or, your insurance does not cover weight loss surgery, you will need to cover your costs yourself. This is referred to as being a self-pay patient. Hospitals offer payment plans for some services allowing you to make payments towards some or all of your expenses rather than being charged in one lump sum. Another option is to pursue private financing from a lender for your medical expenses, but as with any other type of personal loan, you will need to consider the finance charges (interest rate) and fees.

Paying for surgery out-of-pocket, commonly known as self-pay, can be expensive. If you don�t have insurance, or your insurance will not pay for your surgery - as is common with weight loss and plastic surgery - there are ways to afford the health care you need, even if you must pay for the procedure yourself. While self-pay surgery is not ideal, it may be a more attractive option than life without surgery, which may mean living in pain or with an unhealthy condition. Also, even if you have insurance you may need to explore self-pay options, since most insurance pays only a portion of the bill, leaving you to pay the rest.

If you have exhausted your options with your health insurance and Medicare (if that is an option), it may be time to begin investigating alternative methods of financing. Keep in mind that all of the financing options require the funds to be repaid, unlike insurance. Be sure that the costs that you are financing include all of the expected expenses, including the surgeon�s bill, the cost of the surgical suite, anesthesia expenses, hospital care before and after surgery, labs, medications, x-rays and any testing ordered by your physician and visits required before and after the surgery.

In addition, be sure to establish what your payments will be after the surgery prior to having the procedure. You do not want to have a rude awakening when your first bill arrives and your interest rate or payment is substantially higher than you expected. You will also need to plan for any contingencies, like complications, which may elevate the total cost of your care significantly.

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