Many individuals grappling with obesity find that diet and exercise alone are insufficient for achieving and maintaining significant weight loss. In such instances, weight loss surgery emerges as a viable option. With over 250,000 procedures performed annually in the United States, it's evident that many people are seeking this option to help improve their well-being. However, the cost of bariatric surgery can be a significant barrier. This article explores the various avenues for obtaining financial assistance for weight loss surgery, aiming to provide a comprehensive guide for those considering this life-changing procedure.
Understanding Insurance Coverage
One of the first questions individuals researching how to afford weight loss surgery often ask is whether their health insurance plan covers the procedure. The answer depends on individual circumstances and the specifics of the insurance policy. Insurance coverage varies from patient to patient and employer to employer. It's crucial to thoroughly understand your Certificate of Coverage, as every insurance policy is unique.
Some health insurance companies do cover bariatric surgery. For instance, active and retired Louisiana state employees are eligible for weight loss surgery through the Office of Group Benefits. Many insurance plans will cover weight-loss surgery but it is difficult to achieve insurance authorization on your own. To streamline this process, some centers assign each patient a personal authorization specialist. It is important to note that insurance coverage can vary significantly.
Many centers accept both in- and out-of-network insurance plans. However, it's advisable to call the center for details, as “in-network” provider lists are not always complete or up-to-date.
Government Assistance Programs
The federal government offers assistance through Medicaid and Medicare programs to qualified patients. Medicaid provides health insurance to low-income individuals and will cover gastric bypass surgery costs in certain extreme cases. Medicare covers bariatric surgery for individuals who meet specific criteria related to morbid obesity.
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Alternative Financing Options
For those without adequate insurance coverage or who prefer alternative routes, several financing options exist.
Medical Loans and Credit Unions
You may feel surgery is worth the investment in your health and decide to use an alternative financing option such as a home equity loan or medical loan. Some healthcare providers partner with financial institutions to offer financing options. For example, Woman's is pleased to announce financing options through Bayou Federal Credit Union, Campus Federal Credit Union and NOLA Lending.
Crowdfunding
Figuring out how to pay for weight loss surgery without insurance can be stressful. Crowdfunding platforms like GoFundMe offer a means to fund the procedure in a safe space with friends and family while helping reduce the stigma around bariatric surgery for others who need it. Countless individuals have used GoFundMe for medical fundraising to help cover costs, because the investment in your health and quality of life is well worth it. By connecting with donors and sharing your story, you may be surprised by how many friends and family members are willing to step up and lend a hand.
Paul struggled with his weight from as early as five years old. As an adult, he decided he had to make a change when he weighed over 500 pounds and became very ill. To pay for weight loss surgery expenses not covered by his insurance company, Paul turned to his community of friends and family. She started a fundraiser to help her cover the surgery price and raised over $3,200 to put toward gastric band surgery, thanks to supportive friends and family members.
Grants and Foundations
Foundations may offer weight loss surgery grants, covering a significant portion of the procedure cost. The foundation raises funds for weight loss surgery grants covering up to 90% of a qualified weight loss procedure.
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The Bryan Woodward Community Grant Program was founded to support local initiatives in addressing the obesity epidemic in cities that host a Walk from Obesity. Preference is given to those who participated in the Walk from Obesity. Grants are awarded in amounts of $5,000 or less. TREO is not currently accepting requests for this grant.
CareCredit
CareCredit†††Rewards: See Rewards Program Terms at carecredit.com/rewardsterms for details. CareCredit Rewards Mastercard is issued by Synchrony Bank pursuant to a license by Mastercard International Incorporated.
Tax Deductions
The IRS does allow the deduction of weight loss programs including surgery when medically necessary. The cost of surgery must exceed 7.5% of your adjusted income. Other costs delineated by the IRS may help you meet this requirement, including weight loss surgery prep programs, health insurance premiums, post-operative visits, smoking cessation programs and others.
The Role of Financial Consultants
Financing bariatric surgery can be a very stressful process. Some centers designate a financial consultant to each of their patients. These consultants can provide valuable guidance and support in navigating the financial aspects of weight loss surgery.
The Broader Context of Weight Loss Surgery
Weight loss surgery, also known as bariatric surgery or metabolic and bariatric surgery (MBS), encompasses a range of procedures designed to help individuals with obesity lose weight. These procedures work through various mechanisms, including restricting calorie intake and altering gut hormones.
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Types of Bariatric Surgery
Common types of bariatric surgery include:
- Gastric Bypass: This procedure involves creating a small pouch from the stomach and connecting it directly to the small intestine, bypassing a portion of the stomach and duodenum.
- Sleeve Gastrectomy: This procedure involves removing a large portion of the stomach, leaving a smaller, sleeve-shaped stomach.
- Adjustable Gastric Banding: This procedure involves placing a band around the upper part of the stomach to restrict food intake.
Benefits of Bariatric Surgery
Bariatric surgery has been shown to be effective in helping people with obesity lose weight and improve their health not just through restriction of calories but also through a positive impact in modifications of gut hormones, changes in circulating bile acids, modifications in the gut microflora as well as other undefined mechanisms.
Beyond weight loss, bariatric surgery can lead to significant improvements in various health conditions, including:
- Type 2 diabetes
- Cardiovascular disease
- Hepatocellular carcinoma (HCC)
- Asthma
Bariatric surgery has been shown to reduce cancer risk, including a lower prevalence of HCC.
The Role of GLP-1 Receptor Agonists (GLP-1RA)
The recent approval of Glucagon-Like Peptide-1 receptor agonists (GLP-1RA) for weight loss represents a potentially important adjunctive treatment that is receiving widespread interest. Glucagon-like peptide 1 (GLP-1) is a hormone that helps regulate blood glucose levels through improved insulin sensitivity and release of insulin from the pancreas, control hunger, induce satiety and plays a role in the metabolic health of a person. GLP-1 receptor agonists (GLP1-RAs) have been shown to be effective in achieving weight loss in patients with type 2 diabetes while improving blood glucose control.
Given the novel nature of GLP-1RA, there is now considerable confusion and variation in how and when to use either medical or surgical treatment for obesity. To optimize utilization of obesity treatments, there is a critical need to evaluate the impact of GLP-1RA introduction on clinician and patient perceptions affecting decision-making for medical versus surgical obesity treatment.
The combined benefits of GLP1-RAs with bariatric surgery have only been studied to a limited effect. In a randomized trial, the effects of continuation or discontinuation of GLP1-RA therapy in patients undergoing bariatric surgery will be determined.
Addressing Weight Regain After Bariatric Surgery
Despite its efficacy, however, weight regain can occur. Although weight regain can result from anatomic failure (e.g. gastro-gastric fistula), regain is typically multifactorial (e.g. environment, behavioral stressors, new diagnoses). Surgical treatment for weight regain is increasing1, but understanding weight regain physiology and how surgical treatment alters that physiology remains poorly understood. Better understanding of weight regain physiology and MBS treatments remains critically important.
The objective of a study is to evaluate a newly developed Internet-delivered (via e-learning modules) acceptance-based behavioral intervention (ABTi) for individuals who are experiencing weight regain post-surgery. The study is assessing ABTi’s efficacy on stopping and/or reversing weight by comparing it to a wait-list control (WLC) condition. It is also evaluating its effect on targeted weight control behaviors and acceptance-based skills. Finally, it is examining the relationship between weight outcomes and changes in process variables through exploratory analyses.
Bariatric Surgery and Cancer Prevention
Increasing attention is now drawn to the protective effects of weight loss interventions against development of malignancies. As one of the most powerful tools to attain durable weight loss, bariatric surgery has become of greater interest as an intervention against cancers involving endocrine and metabolomic homeostasis, such as breast cancer where bariatric surgery confers up to a 37% risk reduction of breast cancer.
The Impact of the COVID-19 Pandemic
The survey explored public perceptions of obesity and its treatment amid the COVID-19 pandemic. The survey shows public awareness and concerns over the dangers of obesity have never been higher.