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 |  | Medium: Copays, deductibles and coinsurance with insurance coverage |  | High: Typically $18,000-$35,000 without insurance |
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Gastric bypass surgery -- the most common type is called Roux-en-Y gastric bypass -- is a form of weight loss surgery in which the doctor permanently reduces the size of the stomach to a small pouch, then attaches a tube of intestine to the pouch, bypassing about two feet of intestines. This restricts the amount of food the patient can eat and inhibits absorption of some calories.
Typical costs: | - Gastric bypass surgery typically costs between $18,000 and $35,000, depending on the surgeon and geographic region. It usually costs toward the higher end of the range in large, urban areas, especially on the East and West coasts.Cash prices quoted for gastric bypass surgery almost always are for laparoscopic[1] surgery, which is less invasive and has fewer complications than open surgery. For example, according to the Obesity Surgery Center of Louisiana, the typical cash price paid for a laparoscopic gastric bypass is $21,500. At the Videoscopic Institute of Atlanta, Dr. J.K. Champion, M.D. offers laparoscopic gastric bypass surgery for $23,000 to $23,500. The Weight Loss Surgery Centers[2] in Houston, Dallas and Baton Rouge, quote a price of $25,000.
- Gastric bypass surgery sometimes is covered by insurance, but that varies based on the insurance company, the policy, the geographic location and the patient's individual health status and history. Some health plans specifically exclude weight loss surger
- Medicare covers gastric bypass surgery for individuals with a BMI of 35 or higher, an unsuccessful history of weight loss attempts and at least one co-morbidity -- other health problem -- associated with obesity.
- For patients with insurance coverage, it is not uncommon for out-of-pocket costs for gastric bypass surgery -- which often include copays for office visits and coinsurance for surgery, to run from hundreds to several thousand of dollars. For example, federal employees covered by one Blue Cross Blue Shield plan pay 10 percent of the plan allowance for the surgery and a $100 hospital admission fee when using a preferred provider. In a weight loss surgery forum on ThinnerTimes.com[3] , patients share their individual out-of-pocket costs with various insurance companies.
Related articles: Lap Band, Liposuction, Tummy Tuck, Breast Lift
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What should be included: | - The surgeon will meet with the patient to do an initial screening, take a health history, make sure the patient is a candidate for the procedure and clearly explain the options, procedures, benefits and risks.
- In addition to the surgery, the total fee usually includes the hospital's facility fee and the anesthesiologist's services.
- Routine follow-up visits for the first year after surgery generally are included.
- After the surgery, patients must change their eating habits, including eating different types of foods and much smaller portions, in order to feel well and have successful weight loss. The MayoClinic offers general information on the required changes. To help patients maintain these changes, many doctors include lifetime membership in a support group.
- Benefits can include loss of large amounts of weight, lowering of cholesterol and blood pressure and improvements in sleep apnea and type 2 diabetes.
- The Mayo Clinic[4] offers a primer on gastric bypass surgery.
Additional costs: | - Patients sometimes have to pay additional fees of a few hundred dollars or more for consultations with a nutritionist and psychologist, before and sometimes after surgery.
- Patients should be aware that surgery complications can result in extended hospitalizations and even the need for further surgery, which can run up medical bills into the thousands and tens of thousands of dollars or more, depending on the situation. To lessen risks, some surgeons use the BLIS program, which is a type of insurance against complications. Usually surgeons who use BLIS build the cost of the premium into the price of surgery and then, if complications occur, the company covers the cost. Even without major complications, patients will have to pay for follow-up visits, usually after the first year.
- Some patients, once they lose weight, require plastic surgery to remove loose, extra skin. Some also choose to have breast lifts, liposuction, or other surgeries.
Discounts: | - A patient who pays for the surgery out-of-pocket might be eligible for tax breaks if the cost is high enough in relation to income. The U.S. Internal Revenue Service[5] has information on medical deductions.
Shopping for gastric bypass surgery: | - A doctor performing gastric bypass surgery should be board certified in general surgery by The American Board of Surgery[6] , and should have extensive additional training in bariatric -- weight loss -- surgery.
- Tip: Ask the doctor what kind of training he or she has in gastric bypass surgery, and how many years of experience performing it. Also ask if the doctor is a member of a professional organization such as the American Society for Bariatric & Metabolic Surgery[7] , which offers ongoing training and support in weight loss surgery.
- Most surgeons only will perform weight loss surgery on obese patients with a body mass index (BMI) of 40 or higher -- which is about 80 pounds overweight for women and 100 for men. However, some will accept patients with a BMI of 35 to 39 if they have additional complications such as sleep apnea. The U.S. Centers for Disease Control and Prevention[8] offers a BMI calculator.
- It is important to be aware of and discuss with your doctor the very serious risks associated with gastric bypass surgery. These include about one death for every 200 to 300 surgeries as well as serious health conditions such as blood clots in the legs, leaking at the staple lines in the stomach, incision hernia and dumping syndrome.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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What People Are Paying - Recent Comments |
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External Resources: | - asmbs.org/
- www.weightlosssurgerycenters.com/
- www.thinnertimesforum.com/topic/2314-does-most-ins-co-pay-for-gb-surgery/
- www.mayoclinic.com/health/gastric-bypass/MY00825
- www.irs.gov/pub/irs-pdf/p502.pdf
- www.absurgery.org/default.jsp?aboutinquiries
- asmbs.org/
- www.cdc.gov/nccdphp/dnpa/bmi/index.htm
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