Insurance companies realize the huge costs associated with the long term health implications of patients with obesity. If the costs to treat weight lose can be significantly reduced after a patient undergoes weight loss surgery then, they see this as a risk worth taking. Insurance companies would rather cover the costs of a gastric bypass operation that will cure the patients problem rather covering the cost of their long term medication and treatment.
Over the past 15 years the number of weight loss surgeries has sky rocketed. In the early nineties the number of procedures was 16,000 and many obesity experts predict that by 2010 the number of procedures will reach the 200,000 mark. The popularity of this surgery has also increased the demand for insurance cover. This means it is not as easy to obtain insurance cover for weight loss surgery today, as it was in the past. Insurance companies are becoming more selective because the average cost to perform this surgery has increased considerably to between $25,000 to $28,000. Another trend is policy holders lack of loyalty. In the past policy holders would stay with their insurance company for life however, that trend is reversing. Instead of loyalty many policy holders are now switching to other providers who offer them a better deal. Many insurance companies no longer see their policy holders as long term investments as they are unable to fully recoup the costs each time they switch.
If you are thinking of applying for insurance to cover your weight loss surgery then, you need to prepare in advance to improve your chances of successfully obtaining the cover you need. Insurance companies will need proof of your condition therefore, you need to obtain a letter from your Bariatric surgeon providing the following information:
1) Your body measurements including your weight, your body mass index (BMI) and your height.
2) Detailed description of your health implications in relation to your overweight or obese condition and including records of the treatment you received.
3) A thorough explanation of how your condition restricts your quality of life.
4) Details of what diets you have taken and there results, plus any exercise programs you have undertaken to improve your condition.
As well as the above information, there are a number of further details that you and your surgeon can include to support your application. For example, many insurance companies require authoritative research and findings relating to the success and possible implications of the weight loss procedure to be undertaken. Some companies request a psychological and emotional evaluation of the patient which, your surgeon should arrange for you.
It is also wise to keep a record of any documentation relating to the treatment of your condition. For example, keep any letters from doctors or specialists that have carried out medical treatment in relation to your obesity. Create a file for the originals and make a copy of each letter and send them to your doctor for appraisal. In addition to this, think of other supporting information you can provide your doctor for example, any allergies you may have or any other conditions that have contributed to your obesity.
The above information should cover the major requirements for most medical insurance companies however, you may have to include further documentation. Your surgeons practice should have an advisory service that can assist you with this as well as answer any questions you may have regarding your application.
