Bariatric surgery, also called weight loss surgery, can help patients lose weight when diets, exercise, and other lifestyle changes have failed. If you're considering weight loss surgery in Louisiana, understanding the costs involved is likely one of your big concerns. This article will discuss typical costs, insurance coverage, and what financial options may exist if you do not have insurance.
What is Bariatric Surgery?
Bariatric surgery refers to several types of weight loss procedures that can help people with severe obesity achieve significant and lasting weight loss. According to the Centers for Disease Control and Prevention (CDC), more than 40% of American adults struggle with obesity, with severe obesity affecting nearly 10% of the population.
"Bariatric surgery isn't just about weight loss," explains Gia Eapen, MD. "It can also potentially help with improvements in obesity-related conditions like type 2 diabetes and hypertension.”
Some common types of bariatric procedures include:
- Gastric Sleeve (Sleeve Gastrectomy): Removes about 80% of the stomach
- Gastric Bypass (Roux-en-Y): Creates a small stomach pouch and reroutes the small intestine
- Gastric Banding: Places an adjustable band around the upper part of the stomach
Qualifying for Bariatric Surgery
To qualify for bariatric surgery, you must have a body mass index (BMI) of 40 or higher. If your BMI is between 35 and 40, you may qualify if you have at least one obesity-related health condition, such as type 2 diabetes, heart disease, or high blood pressure.
Read also: Mexico Gastric Sleeve Options
Average Cost of Bariatric Surgery in Louisiana
The average cost of bariatric surgery in the United States typically ranges from $17,000 to $26,000, according to the American Society for Metabolic and Bariatric Surgery (ASMBS). Bariatric surgery prices range from procedure to procedure and can vary depending on the complexity of the treatment plan.
In Louisiana, if you will be paying cash for your procedure, some practices offer competitive prices. For example, Do It Bariatrics advertises an all-inclusive Gastric Sleeve package at $4,449 USD. This price typically covers all the essential services and amenities to ensure a seamless experience from start to finish.
Factors Influencing the Cost
The costs can include:
- Essential pre-surgical tests and evaluations to ensure you're ready for the procedure
- The main surgical fees that cover your surgeon's expertise and operating room time
- Hospital stay expenses, which vary based on your recovery needs
- Post-surgery care, including follow-up visits and monitoring
- Anesthesia services
- Surgeon fees
- Hospital facility fee
- Anesthesiology fee
Also, remember that costs can vary depending on your location and specific needs. Fees for laparoscopic weight loss surgery vary based on surgeon fees and/or additional testing required.
What's Typically Included in a Bariatric Surgery Package?
Let's look at what's typically included in a bariatric surgery package using Denver Health, a health system in Colorado, as an example.
Read also: Healthy Eating on a Budget
Their bariatric surgery cost package includes:
- Pre-operative bariatric care
- Anesthesia services
- Two-day hospital stay
- Surgeon fees
- Post-operative care for up to 90 days after surgery
At Denver Health, a laparoscopic Roux-en-Y gastric bypass costs around $15,920, while a laparoscopic sleeve gastrectomy is priced at $11,337.
What Costs Are Not Covered?
A bundle price for weight loss surgery may not cover everything in your weight loss journey. You may need to plan for additional expenses like your initial consultation with the surgeon and bariatric psychology evaluations. There are also potential pre-operative requirements such as cardiac clearance, sleep studies, and laboratory tests.
Visits with a bariatric dietitian, however, may be covered by your insurance.
After surgery, you'll have follow-up visits at six months and one year, plus regular lab work at three months, six months, and one-year post-operation. These costs are separate from your surgical bundle, so be sure to factor them in to understand your total financial commitment.
Read also: Diet Coke Price Guide
Insurance Coverage for Bariatric Surgery
Insurance coverage for bariatric surgery depends on your specific plan and insurance carrier. Most insurers require patients to complete physician-supervised weight loss programs before covering the procedure.
"Understanding insurance coverage is crucial," explains Eapen, MD. "Most insurance companies may cover weight loss surgery when specific criteria are met. Talk to your healthcare provider if bariatric surgery is right for you. You may discuss your financial concerns with them as well."
Insurance Requirements
The following are common insurance requirements for bariatric surgery coverage, though specific criteria can vary by provider. Contact your insurance company directly to understand their particular requirements and approval process.
Insurance requirements can typically include:
- BMI of 40+ or BMI of 35+ with obesity-related conditions
- Documented history of failed weight loss attempts
- Completion of medically supervised weight loss program
- Psychological evaluation
- Medical necessity documentation
Medicare and Medicaid Coverage
Medicare covers certain approved procedures like gastric bypass surgery and laparoscopic banding surgery, making it a great option for those who are eligible.
Note: Open sleeve gastrectomy and laparoscopic sleeve gastrectomy procedures are not covered by Medicare, according to the Centers for Medicare & Medicaid Services (CMS).
Most states cover weight loss surgery, but Medicaid rules vary. It’s best to verify the coverages based on your specific state.
Both programs require you to meet certain medical criteria. It's always a good idea to check the exact requirements with your provider to see if you qualify.
Active and retired Louisiana state employees are eligible for weight loss surgery through the Office of Group Benefits.
Financing Options Beyond Insurance
If insurance doesn't cover bariatric surgery, there may be several other payment options that can help you achieve your weight loss goals.
- Personal or Medical Loan: Many financial institutions offer specialized healthcare lending options with competitive interest rates and flexible repayment terms.
- Health Savings Account (HSA) or Flexible Spending Account (FSA): Using tax-advantaged funds like Health Savings Account (HSA) or Flexible Spending Account (FSA) towards your surgery and related expenses is also a potential option to finance your surgery.
- Hospital Payment Plans: Many hospitals and surgical centers offer flexible payment plans to help make bariatric surgery more accessible.
- Borrowing from Retirement Funds: Borrowing from a retirement fund, such as a 401(k) plan, is typically not recommended. However, it is a potential option that you may consider.
- Financing options through credit unions: Woman's is pleased to announce financing options through Bayou Federal Credit Union, Campus Federal Credit Union and NOLA Lending.
Preparing for Surgery and Recovery
No matter which type of bariatric surgery you choose, you will need to use the weeks or months leading up to your procedure to prepare for your recovery and beyond. For your weight loss surgery to be successful, you will need to commit to making significant healthy lifestyle changes both before and after your procedure.
To help ensure that your body is ready for surgery, your doctor may order blood tests, a physical exam, and other diagnostic tests to get a clear picture of your overall health. Don’t be shy about asking your doctor or surgeon any questions you may have during this time. They will be able to give you advice on how to prepare your home for your recovery, as well as give you an idea of what to expect as you heal from your surgery.
The specifics of your surgery will depend on which bariatric procedure you choose. Usually, weight loss surgeries are performed laparoscopically and take anywhere from one to a few hours. You will be under general anesthesia, so you will be asleep for your procedure and feel no pain.
After any bariatric surgery, you will be instructed to follow a strict diet during your recovery. Typically, you will start out with clear liquids and gradually add in more solid foods as your stomach heals. It’s important to follow your doctor’s guidelines for what-and how much-you should eat during your bariatric surgery recovery. Eating too much too soon may cause nausea or stomach pain.
In the months after your bariatric surgery, you will have a few follow-up visits with your doctor. As you heal during your recovery, they will guide you in making healthy lifestyle changes, such as sticking to a nutrient-rich diet and exercising regularly.
The Importance of a Bariatric Diet
"Bariatric surgery is just the start of your weight loss journey," says Eapen, MD. "Long-term success requires a commitment to significant lifestyle changes, especially in how you eat."
Working with a bariatric nutritionist dietitian can help you navigate these dietary changes successfully.
"A weight loss dietitian can personalize the best bariatric diet for you. They will help you understand not just what to eat, but how to eat to maximize your surgery results," explains Eapen, MD. "These experts create unique nutrition plans and provide ongoing support for healthy eating habits that last a lifetime."
Risks of Bariatric Tourism
More and more patients are considering traveling to another country to receive low-cost weight loss treatment. It is not recommended bariatric tourism for a number of reasons, chief among them your safety. The recovery period is the most critical time after surgery. Crossing the border for care puts you at risk of being far from your treating doctor should a complication arise during the healing process after you’ve returned home. The success of bariatric surgery depends on frequent and lifelong follow-up after the operation, which is difficult, if not impossible, when your procedure is performed in another country. We take your safety, comfort, and results very seriously. We’re here to help.
Finding a Surgeon
Surgery by an Experienced Surgeon is vital. The surgeons at The Surgical Specialists of Louisiana perform numerous procedures daily. At our practice, we offer among the lowest cash prices in the state for the most in-demand and effective weight loss procedures available. The most important factor for us is helping you get started on your journey to improved health and reduced disease.
Revisional Weight Loss Surgery
Over the years and for various reasons, some patients may experience weight regain following their initial weight loss procedure. The Surgical Specialists of Louisiana are experts at Revisional Weight Loss Surgery which can be performed laparoscopically or endoscopically.