Do You Qualify for Bariatric Surgery? Bariatric surgery is a big commitment. There's a substantial financial commitment, as well as an emotional and lifestyle commitment. Before your doctor, surgeon and insurance provider will perform the surgery, you have to meet the surgery's qualifications. Meeting these qualifications demonstrates that the benefits of doing the surgery outweigh the risks. Before making a decision, take these factors into consideration. Weight Considerations If you have a Body Mass Index (BMI) of 40 or higher, you probably qualify for bariatric surgery. If you have a BMI of 35 or above, you might qualify for bariatric surgery, depending on your medical history. Cost Considerations The average lap band procedure costs $14,000. Sleeve gastrectomy surgery comes in at $18,000 and gastric bypass costs an average of $22,000. Most gastric bypass procedures are paid for by insurance, rather than out of pocket. Check your insurance provider to see if your policy covers bariatric surgery. Whether or not bariatric surgery is covered depends more on the policy than the provider. Fit for Anesthesia? You have to be fit and in good enough health to undergo extensive anesthesia. Your surgeon will need to examine you to make sure your body can handle the anesthesia without adverse side effects. Proof of Failed Weight Loss Attempts In order to qualify for the surgery, your insurance company will likely require that you have documented proof of attempting to lose weight through other means. Almost everyone who does bariatric surgery has attempted to lose weight through other means. However, to qualify for the procedure, you'll often need to document those attempts. For example, a certified nutritionist or doctor may need to prescribe a diet plan for you. You'll be asked to document your attempts using the diet. Only once you have 3-6 months of failed attempt data would the insurance company then authorize a bariatric surgery procedure. Emotional, Mental and Psychological Requirements Before you go through bariatric surgery, you'll need to take a psychology test. The purpose of the test is to assess your current mental condition. Psychological issues that may be linked to over-eating may need to be addressed before continuing with the procedure. These issues could include depression, anxiety or impulsive behavior.
Understanding and Commitment to Post-Op Program Bariatric surgery isn't a "do it and forget it" solution. After the operation, you'll need to continue to follow a supervised diet and attend regular medical follow-ups. Patients who follow the post-operation program are far more likely to keep the weight off. Potential complications can be detected early on through blood tests and vitamin tests. These are the most important requirements to qualify for bariatric surgery. As always, talk to your doctor about your specific situation. Exceptions can be made depending on your medical history and insurance policy.