Patient criteria for Lap-Band surgery includes individuals 100 pounds or more above ideal body weight, or a BMI of 40 or higher, or a BMI of 30 or higher with obesity-related health conditions.
Friday March 27, 2015
Bariatric Surgery is often the last resort for someone who is morbidly obese and has tried for years to lose the excess weight. But even if a person is a qualified candidate for lap band surgery, who is going to pay for the weight loss procedure? At an average cost of $25,000 without any complications and double that if there are, the financial aspect of weight loss surgery is obviously a very significant factor.
While many people may benefit from the surgery, those that end up getting the surgery are only those that can afford it. For some, Lap Band surgery may be covered by their insurance company. For others, they pay for it out of their own pocket, often by arranging financing or getting a loan. What many hopeful patients want to know, however, are there any options available for those that don't have health insurance coverage (or their health insurance doesn't cover bariatric surgery) and just don't have the financial means to pay for it on their own?
Many insurance companies recognize the benefit of lap band surgery and will provide coverage to qualified patients.
Many people meet the qualifications for Medicaid or Medicare assistance, which covers the cost of medical care for many people. Sometimes they will pay the entire bill, sometimes a co-payment is required. To be eligible for Medicaid, you must have a limited income as well as meet certain other requirements, including age, disabilities, citizenship, income and other resources. To qualify for Medicare, you must be age 65 or older, under 65 with certain disabilities (many people with morbid obesity are categorized as disabled under the Social Security Act), or have End-State Renal Disease (permanent kidney failure that requires dialysis or a kidney transplant).
To determine if you qualify, you should contact the appropriate social services agency in your area. If you do not know where the local office is located, the address and phone number can usually be found in the front of most telephone books under government listings. You can also visit the website for either the CMS (http://www.cms.hhs.gov/) or HHS (http://www.hhs.gov/) if you want to search for additional information.
The program recognizes that weight loss surgery may be beneficial for some morbidly obese patients and has recently expanded its coverage of bariatric surgery. Lap Band surgery, just like any medical surgery, has both benefits and risks.
While a patient may be morbidly obese and submitted for consideration for Lap-Band surgery, approval is not a guarantee. It is up to the agency to review each patient case by case, and consider all applicable facts. Because of the issues involved in weight loss surgery, there is a very careful approval process for lap-band surgery.