Getting Bariatric Surgery Under Insurance – Things To Know
Are you in need of a weight loss surgery and wonder if your health insurance will cover it? Then you are in the right place. With the rate of obesity on the rise, many people choose bariatric surgery as an alternative to lose weight. Nowadays, when exercise, diet and fitness fail, some people prefer this procedure too.
Let’s determine the types of bariatric surgery or weight loss surgery and how health insurance can help. Last year, October 2019, according to IRDAI (Institute of Insurance Regulation and Development in India), bariatric surgery or weight loss surgery was added to health insurance. Inclusion of family health insurance and individual health insurance or even critical illness policies is expected to benefit nearly 38% of people in rural areas and 30% of India’s urban population.
Moreover, you can effortlessly search for it on our website https://www.bariatricsurgeonindia.com/. But before that, let’s read some crucial details about the whole procedure.
What is Bariatric Surgery?
People who are overweight and have a higher BMI even after walking and exercising need weight loss. After a doctor recommends bariatric surgery to avoid future health problems, health insurance will be covered. This is a safe procedure that will help you lose weight and lose weight.
Bariatric surgery is recommended for people with a body mass index (BMI) of 40 or more. This surgery is recommended for people suffering from obesity and weight-related severe health problems such as cardiovascular disease, type 2 diabetes, high blood pressure, sleep apnea, etc.
Patients should follow a unique diet plan before bariatric surgery and subsequent exercise to avoid weight gain after surgery. Although bariatric surgery is a safe alternative for weight loss, there are certain risks, including infection, blood clots in the lungs, and internal bleeding.
What procedures can be performed under bariatric surgery insurance?
Some of the standard procedures that are covered by bariatric surgery:
- Roux-en-Y bypass
- Sleeve gastrectomy
- Laparoscopic Mini Gastric Bypass
After the procedure, a person’s ability to eat is impaired, which results in weight loss. After surgery, a person has a smaller stomach that can only hold a few ounces. Additionally, some weight loss surgeries limit nutrient and calorie absorption. If you are having this procedure, you will also need to take nutrition and behaviour classes to help with life after surgery.
How much does bariatric surgery cost?
The bariatric surgery costs around Rs. 2.5 lakh to Rs 5 lakh and the price will depend on other factors, including the type of surgery, hospital, Bariatric surgeon fee and many more. Other additional costs include the cost of surgical instruments, anaesthesia, and aftercare.
Obesity-related health problems resolved after surgery:
- Liver obesity
- Gastroesophageal reflux disease
- High blood pressure
- Respiratory disease
- Urinary stress incontinence
- Sleep apnea
- Venous stasis
Does health insurance cover bariatric surgery?
Health insurance now covers bariatric surgery if you meet the requirements. Insurance coverage depends on the health insurance you choose. Health insurance companies in India accept obesity, comorbidities or life-threatening conditions as stated in the policy. If your doctor recommends bariatric surgery, you can get a cash replacement. Generally, you will need to provide evidence to the insurer that the operation is medically essential.
Until 2019, bariatric surgery was a standard exception to medical care policies. However, with advances in technology and new IRDAI guidelines, many insurance companies pay for bariatric surgery. However, these benefits are only available when medically necessary and are not used for cosmetic purposes.
How does bariatric surgical insurance work?
A few years ago, bariatric surgery was the exception to the standard across the industry. With changing world needs and technological advances, bariatric surgery is currently being considered by many insurance companies. If you are admitted to the hospital for bariatric surgery on the doctor’s advice, which is medically necessary, the insurance company will cover the associated medical costs. However, keep in mind that bariatric surgery benefits can only be used when medically necessary and not for cosmetic purposes.
Is there a waiting period for bariatric surgery in health insurance?
The health insurance waiting period is valid for bariatric surgery and varies between 2 and 4 years. So if you want to claim bariatric surgery costs, you can do it after the waiting period after purchasing the policy.
What are the health insurance exemptions for bariatric surgery?
Regardless of whether it is health insurance or family health insurance, the following exceptions apply to bariatric surgery:
- Claims submitted within 30 days of the inception of the contract are omitted
- Claims from previous conditions are also not covered
- Cosmetic/aesthetic reasons
- Drug-induced obesity, mental and eating disorders caused by obesity, and untreated hormonal imbalance
- The best way to take advantage of bariatric surgery health insurance benefits is to do thorough research before buying health insurance online.
What types of bariatric surgery should be claimed?
When filing a claim for bariatric surgery under your health insurance, you must meet the following requirements and provide the following documents:
- The surgeon is prescribed for diagnostic tests and permission to operate
- Policyholders must also submit a medical report and description to file a claim for bariatric surgery costs. The patient must have a BMI of 40 or more
- If your BMI is 35 or more, you have health problems such as sleep apnea, type 2 diabetes, and heart problems.
Steps to Take Bariatric Surgery Insurance:
- Most insurance companies recognize the health consequences of obesity and pay for surgical treatment for weight loss. However, every insurance plan is different.
- Therefore, before starting our program, we endorse all guidelines regarding bariatric surgery’s benefits and requirements. Suppose your policy changes after our program has begun. It is imperative to ensure that the new policy considers the benefits of bariatric surgery.
- Once you have completed our preparation program and meet all the requirements set by your insurance company, we will begin obtaining insurance clearance. We will first send your medical records to your insurance company with a request to cover the surgery. It can take two to four weeks for the insurance company.
- We will contact you upon receipt of notification from the insurance company for approval or rejection. If coverage is agreed upon, the patient will be given surgery and a tentative appointment. If insurance coverage is refused, we will investigate the reasons for refusal and proceed with the insurance company’s complaint process.
Bariatric coverage is a new take on how health insurance in India is gradually becoming easier for customers by offering personalized and comprehensive coverage.
Costs for bariatric surgery are not usually covered by basic insurance. Currently, however, insurance companies offer the option of obtaining Bariatric Surgical Insurance as additional coverage for a small additional premium. All you have to do is research your area if you have to pay extra in your health insurance or if all expenses are covered as this varies from plan to plan and from insurance provider to the insurance company.
Dr Venu Gopal Pareek offers various weight loss surgeries to help you achieve your weight loss goals, including sleeve gastrectomy, Roux-en-Y gastric bypass, LAP-BAND®. To find out more about our bariatric surgery options, call us at +91 91-777-77715. The content on our website is provided for informational purposes only and does not constitute medical advice. If you have emergency medical care, call +91 91-777-77715. Always consult Dr Venu Gopal Pareek before making any changes to your medical care.