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Monday, October 8, 2012

005 Insurance, Money and the Kitchen Sink

Last time we talked about the four main types of weight loss surgery (WLS) available. If you interest has been piqued then I am sure you are starting to wonder how much it’s going to cost you and what you may or may not have to do to get insurance coverage for a WLS. I can only answer these questions from our perspective and give you tips on how you can find out how these things are going to apply to you.

Let’s just go ahead and get the easy question out of the way...

Q: How much will a WLS cost me?

A: No one has an exact amount. It varies from person to person and hospital to hospital. However, for an estimate of the cost you will incur you should contact the WLS program/center/doctor you are planning to use. They should have a pretty good idea of how the money will come out in the end because they do this all the time.

Keep in mind that there are many factor that will determine the cost of your WLS:

• Surgeon performing the surgery
• Time spent recovering in the hospital
• Complications or lack of complications
• Number of care providers overseeing your case

Q: Will my medical insurance cover WLS?

A: Each insurance carrier is unique. Be sure to check with your insurance provider before undergoing surgery as the types of surgery covered and the requirements for coverage vary widely from one provider to the next. A good surgery program should help you to file your insurance paperwork and receive pre-authorization of coverage for your surgery before you ever schedule your operating room time.

Q: What are some common insurance requirements for WLS coverage?

A: I can’t tell you for sure about your insurance company but I can tell you about ours. But I am not going to do that until next time...

So stay tuned.


  1. I have BCBS of Minnesota and it's pretty much the same. Not only will the insurance company have it's requirements but your surgeon's office may have it's own set of guidelines. At the Iowa Health Weight Loss Center in Des Moines I was also required to-
    1. Attend a seminar explaining all the types of bariatric surgeries before I could schedule an appointment.
    2. At the 1st appointment I met with the surgeon, the dietitian and was assigned an insurance liasion.
    3. Two evaluations by a psychologist.
    4. Cardiac clearance if you are over 50.
    5. Attend a support group meeting.
    My 1st step was the informational seminar on Feb. 3 of this year and I had my gastric sleeve procedure on Sept. 27. I feel wonderful and it's the best thing I have ever done for myself!

  2. Thanks for sharing! You are absolutely right about the surgeon's office having their own requirements. We also had to go through an informational seminar before we could schedule Jimmy's first appointment. They don't require the support groups but they do highly recommend them and they have two that operate out of their offices. Again, thank you so much for sharing and for reading!