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Armchair research is easy with the internet, but when it comes to bariatric surgery, the cheapest option may not be in your best interest.
Did you know that almost half of all bariatric patients will bring information they found online to their clinicians?1 Patients today have more access to health information than ever before, and many people start with an online search rather than a doctor.
That access to information, alongside due diligence in sourcing it, can help patients better understand obesity, bariatric surgery, and the questions they want to ask during a consultation. One of the top questions is about cost, and it’s one of the biggest drivers of a patient’s decision on the type of procedure they prefer.1 It’s an important detail.
Before we jump into discussing financial figures and the cost to your health, we want patients to know that choosing a bariatric procedure involves more than comparing costs or reading about outcomes online. The most appropriate procedure depends on a comprehensive evaluation of each patient’s health, anatomy, medical history, and weight loss goals. Discussing conversations with friends, information shared on social media, or research you’ve done online, including cost analyses, with an experienced bariatric surgeon can help place that information into the proper medical context.
Analysing Various Costs
The cost of bariatric surgery varies quite a bit depending on the procedure performed, geographic location, hospital fees, anesthesia costs, surgeon fees, length of stay, and insurance coverage. In general, sleeve gastrectomy is usually among the lower-cost bariatric procedures, while more technically complex operations such as duodenal switch (BPD/DS) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) tend to be associated with higher costs.
Some procedures provide greater weight loss or metabolic improvement for certain patients, while others may be more appropriate based on anatomy, gastroesophageal reflux disease (GERD), previous abdominal surgery, or other health factors, so a cursory price comparison doesn’t really give you a complete picture.
Insurance also changes what a patient pays out of pocket. A lot of commercial insurance plans, Medicare, and some Medicaid programs cover bariatric surgery when medical necessity criteria are met. Specific coverage requirements and approved procedures vary by plan, and it’s important to make sure you get to know your benefits. A little extra effort in that department can help you better understand treatment options and avoid unexpected expenses.
Some patients may also qualify for Lantern’s Network of Excellence low-cost bariatric surgery program as an eligible member of the North Carolina State Health Plan. Through this initiative, patients receive top-tier access to bariatric surgery facilities and comprehensive support. To learn more about this program and whether you qualify, click here.
Patients should also keep in mind that surgery itself is only one component. Nutritional counseling, follow-up visits, laboratory monitoring, and vitamins and supplements are also part of the process and overall cost of bariatric treatment.
Another cost consideration that often falls by the wayside is the financial impact of obesity itself. Adults with obesity incur substantially higher healthcare expenses than adults without obesity.2 Additional healthcare expenses can become significant, particularly when obesity-related conditions such as type 2 diabetes, hypertension, sleep apnea, heart disease, and joint problems require ongoing treatment. In a broader consideration of insurance coverage and long-term healthcare expenses is quality of life and the potential health benefits associated with sustained weight loss.
Coverage and Financial Considerations of Revisional Surgery
Most patients will achieve significant and lasting benefits from bariatric surgery. However, there are situations where an additional procedure may be recommended. Revisional bariatric surgery is performed to address complications from a previous operation, improve weight loss outcomes, or convert one procedure to another when a patient’s needs have changed over time. Severe gastroesophageal reflux disease (GERD), weight regain, insufficient weight loss, an enlarged gastric pouch, complications related to a gastric band, or other anatomical changes that affect the original procedure’s effectiveness are some of the more typical reasons revisional surgery may be appropriate.
The cost depends on the complexity. In some cases, a revision can be less extensive than the original operation. In others, it can be more technically complex and involve greater costs.
Insurance coverage for revisional bariatric surgery is a little bit different than the coverage for a primary procedure. Most insurance plans require it to be considered medically necessary with proof from the physician. Documentation of complications, objective testing, medical records, and evidence supporting the need for revision are part of the approval process, and not all revisions are automatically covered.
At Bariatric Specialists of the Carolinas, we want you to bring your questions. Online information, articles, conversations you’ve had, and any concerns you have about cost or insurance coverage, it’s all welcome. We want to help you understand your options based on personal health needs. Sometimes, the least expensive option is not the most appropriate one.
References
- Huynh, R., Satchithanandha, V., Park, J. S., Seyfi, D., & Joseph, D. (2024). Online Search Trends Related to Bariatric Surgery and Their Relationship with Utilization in Australia. Obesity surgery, 34(9), 3412–3419. https://doi.org/10.1007/s11695-024-07457-1.
- Cawley, J., Biener, A., Meyerhoefer, C., Ding, Y., Zvenyach, T., Smolarz, B. G., & Ramasamy, A. (2021). Direct medical costs of obesity in the United States and the most populous states. Journal of managed care & specialty pharmacy, 27(3), 354–366. https://doi.org/10.18553/jmcp.2021.20410.
