You’ve made the life-changing decision to pursue bariatric surgery, and now you’re wondering how you should pay for it. Should you go through insurance, or should you self-pay? For some patients, the decision is simple: if you don’t have insurance or if your insurance doesn’t provide bariatric benefits, than self-pay makes the most sense.
But even if you have bariatric benefits through your insurance provider, it might still make sense to pay cash for your weight loss surgery. Here are 5 reasons that self-paying for weight loss surgery might be the right decision for you.
1) The Insurance Approval Process Can Be Frustrating
Submitting an insurance claim for weight loss surgery can be a time-consuming process. Before insurance will consider approving a patient’s claim, they often require a battery of lab tests, assessments, appointments, and exams. Even if you have bariatric benefits, you’ll have to jump through a number of hoops just to submit your application.
Even once you submit your application for weight loss surgery, your insurance may still deny your claim. This happens far more often than it should. For gastric bypass surgery, for
instance, almost half of prior authorizations in some areas are not approved. Some high deductible plans also leave their patients to pay a deductible that is similar to the self-pay surgery amount. Additionally, even if your claim is approved, some patients find that getting the reimbursement check in the setting of some direct to employer or co-op plans can take several months.
2) You Can Get Surgery Faster
In line with the first reason, self-paying for weight loss surgery means that you can often get bariatric surgery more quickly than if you had to go through your insurance. Partly this is because self-paying for bariatric surgery means you don’t need as many lab tests, assessments, and exams before the bariatric surgery process can get underway. Another reason is that insurance companies often mandate that patients undergo a six-month medically-supervised weight loss class before surgery. For many patients, once they make the life-changing decision to pursue weight loss surgery, they want to undergo surgery now rather than wait an entire half-year to begin the process. This is especially salient if you’ve already struggled with obesity for a large portion of your life.
At the Bariatric and Metabolic Center of Colorado, we offer a Fast Track program for patients who are doing self-pay and who want to accelerate their weight loss journey.
3) More Freedom to Choose Your Bariatric Surgeon
Insurance providers sometimes require you to pick a hospital and bariatric surgery center that are in your network, but this might not be the right surgeon or program for you. Getting weight loss surgery is one of the biggest decisions of your life, and your decision of who should perform the surgery is profoundly important. Many patients choose to self-pay for bariatric surgery because they want to make this decision themselves, rather than feeling limited to a list of surgeons approved by their insurance provider.
4) More Freedom to Choose the Bariatric Surgery That’s Right For You
The unfortunate fact is that some insurance providers will only cover specific bariatric surgeries. For example, many insurance providers still cover LAP-BAND® surgery, but safer gold-standard procedures like the sleeve or duodenal switch may actually have a lower rate of approval by insurance companies in some cases. The specific bariatric surgery that you choose is of vital importance. If you suffer from type 2 diabetes, for instance, then gastric bypass or duodenal switch surgery will give you your best chance of curing this disease in addition to helping you lose weight and keep it off. Many patients self-pay because they want to make this decision themselves, in consultation with their bariatric surgeon; rather than having the choice made for them by an insurance company that may not understand their specific needs.
5) Self-Paying for Weight Loss Surgery Can Actually Cost Less
Many patients expect that going through insurance will reduce their final bariatric surgery cost, but the truth is that sometimes self-paying for weight loss surgery can actually be more affordable. One reason is that, if your insurance plan already has very high copays and deductibles, then you will need to pay those out of pocket before your insurance covers any remaining cost. Another reason is that using your insurance can lead to a resulting increase to your premiums in the following year because insurance companies try to recoup the cost by adjusting premiums. So while choosing to go self-pay may have a higher cost up front, it may also save some money in premiums down the road.
Finally, some bariatric surgery centers and not-for-profit hospitals offer cash-pay options that are designed to be affordable. They will usually offer a far lower price to cash-pay patients than to insurance companies. At the Bariatric and Metabolic Center of Colorado, we have some of the lowest cash-pay prices in the Denver area. Additionally, all of our cash-pay bariatric surgery prices include preop care, education, surgery, anesthesia, hospital stay, and 3 months of bariatric aftercare.
Other Payment Options
What other payment options are available for bariatric surgery, and how do these options compare to self-pay in terms of cost and convenience? The most common payment option is to go through insurance. Going through insurance often offers patients less convenience and choice than self-pay, but can reduce costs (though it can also be more expensive in some cases).
Taking the Next Step On Your Weight Loss Journey
Ready to take control of your health and transform your life? Contact our bariatric surgery clinic today and see how we can help you lose weight and keep it off.
Our patients routinely say that surgery was the best decision they ever made.
“I feel like I have won the lottery and have been given a second chance in life! March 25, 2014, was the first day of the rest of my new life and I can’t even start to express in words how grateful I am.”—Rochelle Goforth, patient.
If you’re ready to transform your life, don’t wait. Schedule your consultation now.