How much does Bariatric Surgery Cost with or without insurance?

Obesity and its related disorders have haunted the American people for decades. Clinical obesity, a condition that affects one out of every six Americans, brings a host of potentially life-threatening conditions in its wake. Cost aside, extreme weight loss surgery would seem to be a miraculous solution to the problem. The evidence to date suggests that surgery can improve or cure up to thirty obesity-related illnesses, nearly all of which have been on the rise in recent decades. The expense, however, should not be taken lightly. Bariatric surgery costs go beyond the relatively simple realm of dollars and cents and embrace peripheral costs, unexpected costs, and even the hard-to-quantify costs of risk versus reward assessments. The following is a guide to bariatric surgery costs with or without insurance, its associated risks, and other factors that will help you decide whether weight loss surgery is worth having.

Types of Weight Loss Surgery

Before discussing the costs, it’s worth clarifying just what is meant by the term. Bariatric surgery is a broad field, and many different surgical procedures are available. Each procedure is unique, and each will have its own laundry list of direct costs, related expenses, and risk profiles.  The surgery basically comes in two types: one kind restricts your food intake, and the other interferes with your body’s ability to absorb nutrients from the food you eat. The former, often referred to as lap band surgery or stomach stapling, is more commonly performed. This category includes gastric bypass, adjustable banding of the stomach, and vertical banding. The direct costs usually depend on which procedure you choose, where you have it done, and the expertise of your surgeon. As a rule, however, you can expect the bill to fall in about the $20,000 to $35,000 range estimated by the National Institute of Diabetes and Digestive and Kidney Diseases.

Are You a Candidate?

The FDA has approved the use of one form of weight loss surgery, adjustable gastric bypass (AGB), for patients who have a body-mass index (BMI) of 35 or higher and have at least one obesity-related disorder, such as type 2 diabetes. As with any medical procedure, the risks associated with bariatric surgery must be counted as part of the overall bariatric surgery cost.

A Matter of Tradeoffs

Deciding in favor of getting adjustable gastric bypass or any other form of weight loss surgery is largely a balancing act. On the one hand, you’ll be taking on the risks of an invasive surgery under general anesthesia, and on the other, you’ll be greatly reducing the known risks of remaining obese, such as diabetes, high blood pressure, heart disease, and stroke. The damage done by these illnesses is so great that the relatively minor risks of surgery, not to mention the typical cost of bariatric surgery, are considered to be largely secondary to the far more important goal of helping you lose weight quickly and safely.

Factors Contributing to Surgery Cost

Bariatric surgery costs money, but exactly how much will be determined on a case-by-case basis and usually depends on a number of factors. What type of surgery you’ve chosen to undergo will be the dominating factor. A sleeve gastrectomy or gastric binding might have a direct cost of around $15,000, while a more invasive procedure, such as Roux-en-Y (gastric bypass) will often cost something more like $21,000. Other important factors affecting the cost will be the location of the surgery—the Mayo Clinic will obviously charge more than the county hospital—and time spent in the hospital in recovery. These costs vary widely not just from one facility to another but often from one patient to another. Your best bet is to get a written estimate of your specific surgery cost before agreeing to the procedure.

Getting Insurance to Cover Costs

The risks associated with continued obesity are so great that most insurance plans now anticipate the need to cover at least some weight loss surgery costs. After all, they reason, it’s far better to make a single payment of $20,000, or even $35,000, than to bear the costs of a diabetic with high blood pressure who’s in and out of the hospital with congestive heart failure. While the iron logic of the balance sheet has persuaded most insurance companies to pick up the tab for bariatric surgery, it’s essential that you check with your carrier beforehand. Only then can you really know how much of your bariatric surgery cost will be covered for you. You can learn more in our guide to bariatric surgery insurance and financing.