Insurance Bariatric Surgery
Non-cosmetic insurance bariatric surgery is usually performed on individuals who experience life-threatening health issues due to excessive weight. While some patients opt for weight-loss surgery to trim a waistline or to look ten years younger, some men and women have no choice but to undergo drastic operations to lose life-threatening unwanted pounds. Chronic ailments, such as high blood pressure, heart disease, acute joint pain, osteoarthritis, high cholesterol, sleep apnea, and diabetes sometimes plague those who battle obesity. Pressure on hips and knees may cause joins and cartilage to deteriorate, leading to permanent crippling disability. Morbidly obese patients may experience difficulty breathing, sleeping or moving comfortably. Some become confined to a bed or wheelchair and lose the ability to hold down sustained employment or lead an active life. The sheer weight of excess fat increases pressure on bones and vital organs: lungs, heart, kidneys, and spine. Many females are unable to bear children.
When health conditions are exacerbated by obesity, doctors may recommend insurance bariatric surgery, an operation which reduces the size of the patient's stomach to reduce the amount of food and number of calories consumed; or causes food not to be absorbed. Insurance bariatric surgery may take several forms, including gastric bypass, which surgically redirects food into a smaller area of the stomach; adjustable gastric banding, which ties off a portion of the stomach to decrease the size; or stomach stapling. Insurance companies require patients to complete a six-month program of physician-supervised diet and exercise, psychological evaluation, and nutritional assessment prior to approving weight loss surgery.
The six-month diet and exercise program will demonstrate to the firm that patients have tried unsuccessfully to lose pounds under a doctors oversight. The psychological evaluation may reveal underlying causes of obesity, such as binging, bulimia, or mental and emotional illnesses. Therapists may want to address these underlying factors before proceeding with radical gastric surgery. Some psychological and lifestyle changes may have to be altered before the insurance company will approve procedures. A nutritional evaluation will help disclose poor dietary habits, allergies, or other factors which have contributed to severe weight gain. A diet high in fat, sugar, or carbohydrates is usually a factor in obesity. Candidates for insurance bariatric surgery may respond well to a low-fat, low-carb diet or other restrictions which limit caloric intake, yet provide sufficient nutrients for weight loss and better health. "Bless the Lord, O my soul: and all that is within me, bless His holy name. Bless the Lord, O my soul, and forget not His benefits: Who forgiveth all thine iniquities; who healeth all thy diseasesWho satisfieth thy mouth with good things; so that thy youth is renewed like the eagles" (Psalm 103:1-3, 5).
Insurance firms will require documentation and diagnostic findings from physicians, psychologists, and nutritionists. The patient's doctor must submit a preauthorization letter to the insurance company which substantiates the patients medical history, along with a record of chronic or life-threatening ailments impacted by obesity. Patients must have a Body Mass Index (BMI) over 40, be at least 18 years of age, and must have sustained morbid obesity for over five years. Candidates must also be apprised of the dangers and risks of insurance bariatric surgery and sign a statement indicating full knowledge of possible adverse outcomes. Patients run the risk of dying from post-operative complications, such as infection, hernias, and blood clots. Smaller stomach pouches can become dilated; and the urge to overeat will result in "dumping" or vomiting food that the new smaller stomach cannot hold. Alopecia areata, a condition which causes hair to fall out in clumps leaving circular patches of scalp, is another side effect of bypass surgery. Chest pain, constipation, and vitamin deficiencies are other uncomfortable effects of having weight loss procedures.
Underwriters may agree to pay for expensive weight-loss procedures if the life of the insured can be prolonged; or if physicians can demonstrate that without surgery, a patient's lifespan would be greatly shortened. Depending on the extent and complications of insurance bariatric surgery, costs can range from $15,000 to $35,000. Complications, such as bleeding at the incision or post-operative infections can cost even more. Agencies treat physician-diagnosed morbid obesity just as any life-threatening illness. Unlike patients who decide to undergo the knife for cosmetic reasons, morbidly obese patients are fighting for their very life. For some, the likelihood of reaching the age of 50 or 60 is impossible without taking drastic measures.
All portions of approved insurance bariatric surgery may not be covered under patients' policies. Insured individuals need to study provisions to make sure that coverage is available and may have to arrange for payment of portions that are not included. Agencies which provide 100% coverage for weight-loss surgery are responsible for paying physicians, surgeons, anesthesiologists, lab technicians, and any independent contractors involved with the operation. Agencies that disapprove applications may accept appeals from the patient's physician. If companies still balk at paying for weight-loss operations, patients have a right to appeal to the state insurance commission, especially in cases where life or quality of health will be greatly compromised without the procedure.
In the event that state commissioners deny claims, and doctors still feel that surgery is warranted; patients may have to secure financing. Hospital business personnel may offer favorable financing options, such as low-interest installment plans. Other financing options include bank loans, tapping into savings, or charging credit card accounts. Before the operation, patients usually have pre-operative examinations, possibly a heart catheterization to determine if the organ is strong enough to sustain lengthy insurance bariatric surgery. Patients can expect to lose as much as 100 pounds within one year after the procedure as they adhere to a prescribed diet and exercise plan. Weight-loss patients with approved coverage can soon look toward enjoying a new body, a new outlook, and a second chance at a healthy life.
Bariatric Treatment CenterTurning to a bariatric treatment center can make all the difference for individuals who struggle with obesity and weight control issues. Loosing between eighty and one hundred pounds is a monumental challenge. In some cases, surgery is the only feasible alternative. A reputable medical facility can help patients through the process of understanding the procedure and what they can expect. Once the surgery has taken place, it is not simply a matter of recovering and waiting for the weight to drop off. Support systems for after the surgery are very important. This support could include psychological counseling, nutritional information, and a cardiovascular exercise plan that is tailored to the needs of the individual. When shopping around for a bariatric treatment center, all of these issues should be taken into consideration. Research is uncovering new treatments and procedures for obesity on a regular basis. The skilled medical professionals at these facilities will take the time to keep up with all the latest medical breakthroughs and will inform patients of all available options.
In some cases, a bariatric treatment center may be able to do certain types of procedures on an outpatient basis. Handling many of these procedures without a hospital stay can significantly reduce cost and is often preferred by the patient. Of course, each patient and procedure will be different, and a physician can advise patients on what is best for their particular situation. Most centers will also provide educational resources and information for potential patients. Included in that information will generally be facts about the negative impact of obesity on the health of the individual. Problems such as high blood pressure, diabetes, orthopedic issues, heart disease, and sleep apnea can result from being overweight. High cholesterol and arthritis may be present as well. To qualify for bariatric surgery, a patient will usually need to be at least eighty pounds overweight. A track record of failure at loosing weight through other methods will generally be required as well. For many patients, gastric procedures are the only avenue of hope that is left. Support for the necessary post surgery lifestyle changes is very important. Learning to avoid unhealthy foods and to exercise on a regular basis is key if the patient wishes to maintain their weight loss.
A bariatric treatment center might make a number of different options available to patients. Gastric bypass operations involve surgically reducing the stomach. The word bypass comes into play because a section of the small intestine will be bypassed in the procedure. This is done to limit the absorption of food. A combined result of a stomach that can only hold a limited amount of content along with a reduced amount of food absorption will naturally lead to significant weight loss. Another procedure, the adjustable gastric band, involves placing a snug band around the upper part of the stomach. Both surgeries will result in a limitation on the amount of food that a patient will be able to eat at one time. Deciding to take advantage of either of these procedures is not a decision that should be taken lightly. A detailed consultation with a specialist at a reputable bariatric treatment center can help patients and families decide if this it the appropriate step for them.
Many patients have questions about what insurance will cover when it comes to bariatric surgery. Most policies will provide coverage, but a patient will usually need to meet certain standards. Some may only provide reimbursement months after the procedure, and then only if the individual participates in a specified follow up regimen. Documentation of a patient's efforts at weight loss through traditional means may be required as well. If a patient has no coverage whatsoever, many times a bariatric treatment center will offer payment plans and financing options. Once the patient has recovered from the surgery, there are a number of health benefits that they may see as the weight comes off. Cholesterol can improve greatly as can other health issues such as high blood pressure and diabetes. Acid reflux and sleep apnea will usually see improvement, and in many case, the disease will disappear all together. In a gastric bypass operation, patients will sometimes experience difficulty absorbing nutrients and may need to take supplemental products to counteract this. As with all surgeries, complications can arise. Symptoms such as abdominal cramps, constipation, or vomiting would indicate that the patient should consult their doctor immediately. A post surgery regime of nutrition classes and dietary counseling are very helpful and may be mandated by insurance.
Often a bariatric treatment center will take a multi pronged approach to providing the best care for patients. Once a patient has recovered from surgery, a center might help a patient participate in an exercise program. Exercise programs will obviously carry many benefits for the patient. These benefits could include an improvement in the elasticity of the skin as well as helping the patient maintain muscle mass. Metabolic improvements can be another benefit. The stress reducing properties of regular exercise are well documented. Cardio-vascular health can be greatly improved as well. Many times a bariatric treatment center will have professionals on hand who can help patients come up with a plan that is tailored to their needs, preferences and access to exercise equipment. Believers are told in the Bible to be honest and honorable and to love without deception. "Let love be without dissimulation. Abhor that which is evil; cleave to that which is good." (Romans 12:9)