Metabolic or bariatric surgery is a minimally invasive procedure to treat both obesity and type two diabetes. It’s also proven. A substantial number of long-term studies of bariatric surgery have shown people experience a profound improvement in their health, along with major improvements or complete resolutions to high blood pressure, type 2 diabetes and sleep apnea, and a big reduction in mortality risk. But what does bariatric surgery cost?
The Role of Insurance
For most people, the cost for bariatric surgery is mostly paid by the health insurance plan, since it is a covered benefit. You pay your health insurance premiums – which we all know are getting pricier every year – and the hospital and doctors are paid by the insurance plan. You might have a co-pay or a program fee, and we will get to that in a minute.
For others, the insurance plan does not cover bariatric surgery despite its proven benefits as being the best treatment for obesity and type two diabetes. So the cost is born by the individual. How much will it cost in that case?
In the United States, the price ranges from around $13,000 up to $19,000, all inclusive. Inclusive means it should cover all the costs and that you won’t get nickeled and dimed for x-rays or lab tests or an assistant doctor, things like that. Usually, at the best centers the cost includes everything, meaning doctors, anesthesiologist, nursing care, the hospitalization with one or two night stay, followup visits for a specified period, laboratory and x-ray studies, even a pathology report on the stomach tissue specimen. It also includes, or should include, a protection against complications so you are covered if there had to be a return trip to the operating room or treatment for some other complication. This is like an extra insurance policy, and it’s an expensive premium, often as much as 15% the cost of the surgery. But it’s worth it to have the peace of mind and not have additional financial exposure.
In most places, the cost breakdown is somewhere along the following lines:
- Hospital: Aout 60% of charges, and this includes the laboratory and nursing care and hospitalization.
- Surgeon: About 25-30% of charges, and this includes their support employees, follow up visits, program fees, education, preparation and office visits.
- Protection coverage for complications: About 10-15% of charges.
In most centers, the overall fee includes nutritional and psychological evaluations, educational classes and materials, the initial consultation, and office visits. For most patients whose insurance covers the surgery, these important but ancillary aspects of the care are covered through a program fee that can range from a few hundred to several thousand dollars.
Like other top centers, Sasse Surgical has been a fierce advocate for people who need metabolic surgery, working to educate insurers and expand coverage. Many employers do not cover metabolic surgery because they do not understand it would reduce their costs, while significantly improving the health and productivity of their employees. Sasse Surgical has also worked to reduce the out-of-pocket cost for metabolic surgery, negotiating with the hospitals and centers to bring about a 30% price decline in recent years. Special packages that include future excess skin removal are also available to reduce out-of-pocket costs.
Safety is the top priority of the best surgeons and the best centers. No amount of cost savings is worth the risk of going to a bargain bariatric program, no matter what country it is in. If you’d like to learn more about bariatric surgery, contact the Sasse Surgical team today.