Gastric Bypass
Surgery Cost

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), gastric bypass surgery costs very widely from state to state. Whether or not the procedure and related costs are covered by health insurance depends on your insurance company, your state, and your specific policy, among other factors. We recommend you contact us to see what options are available for your specific case. We have assisted thousands of satisfied patients and we would be just as happy to help you!

If you are covered by an HMO, you might need to see your primary care physician to obtain his approval before seeing a specialist like a bariatric surgeon (a specialist who performs bypass surgery). Once you have seen the specialist and have been deemed a candidate for bypass surgery, you will need to begin the pre-authorization process.

The approval process for gastric bypass can be a bit more complicated than it is for other common medical procedures. It is likely that your insurance company will request both your physician and your surgeon send in something called a "letter of medical necessity" as part of the surgery pre-authorization process. Basically, your doctors will relate to the insurance company how having the procedure will improve your health and overall well-being.

If you are denied pre-authorization by your insurance company, you can appeal the decision. All insurance plans offer an appeals process and they are legally obligated to disclose to you your right to appeal. You are typically allowed a 30 to 60 day window from the date you were denied to appeal. The process usually begins with a letter of appeal being sent in to the insurance company by you, your surgeon and your primary care provider. We have been very successful in getting denials overturned by providing the medical evidence necessary to approve your surgery.

If you do not have insurance to cover gastric bypass surgery, or, your insurance policy has an exclusion to not cover the surgery, you will need to cover your costs yourself. This is referred to as being a self-pay patient. We offer payment plans for some services allowing you to make payments towards some or all of your expenses rather than being charged in one lump sum. Another option is to utilize our private financing from our lender for your medical expenses, but as with any other type of personal loan, you will need to consider the finance charges (interest rate) and fees.

Paying for surgery "out-of-pocket", commonly known as self-pay, is far less expensive that it has been in the past. Studies show that after surgery the patient has increased earnings, experienced less discrimination in the work place and has seen and overall substantial improvement in the quality of their life. . If you don’t have insurance, or your insurance will not pay for your surgery - as is common with weight loss and plastic surgery - there are ways to afford the health care you need, even if you must pay for the procedure yourself. While self-pay surgery is not ideal, it may be a more attractive option than life without surgery, which may mean living in pain or with an unhealthy condition. Also, even if you have insurance you may need to explore self-pay options, since most insurance pays only a portion of the bill, leaving you to pay the rest.

If you have exhausted your options with your health insurance and Medicare (if that is an option), it may be time to begin investigating alternative methods of financing. Keep in mind that all of the financing options require the funds to be repaid, unlike insurance. Be sure that the costs that you are financing include all of the expected expenses, including the surgeon’s bill, the cost of the surgical suite, anesthesia expenses, hospital care before and after surgery, labs, medications, x-rays and any testing ordered by your physician and visits required before and after the surgery.

In addition, be sure to establish what your payments will be after the surgery prior to having the procedure. You do not want to have a rude awakening when your first bill arrives and your interest rate or payment is substantially higher than you expected. You will also need to plan for any contingencies, like complications, which may elevate the total cost of your care significantly.