Buy Health Insurance, Up to 20% Discount
9000+
Cashless Hospitals
99% Claim
Settlement Ratio
4.5 Lacs+
Claims Settled
I agree to the Terms & Conditions
Get Exclusive Porting Benefits
Buy Health Insurance, Up to 20% Discount
Port Existing Policy
9000+
Cashless Hospitals
99% Claim
Settlement Ratio
4.5 Lacs+
Claims Settled
Health Insurance That Covers Bariatric Surgery
Imagine this: you’ve been on countless diets and tried every workout plan, yet your weight remains the same. 😞
In such cases, obesity can lead to serious issues like diabetes, heart disease, and joint pain. Hence, doctors may suggest undergoing bariatric surgery (weight-loss surgery). But here’s the big question: will your health insurance cover it?
The good news is that many insurance providers in India now offer coverage for bariatric surgery, but there are conditions and fine print you need to know. In this article, you will learn what types of bariatric surgery are, why they are important, and when you are eligible for them.
Table of Contents
What is Bariatric Surgery?
In simple words, weight-loss techniques involving surgery are called Bariatric Surgery. These operations aim to alter the digestive system to help with weight loss. It is a safe process that can assist patients in losing weight and eliminating extra pounds.
While some operations may limit the quantity of nutrients your body can absorb, others may limit the amount of food you consume. These procedures are usually only recommended when diet and exercise have not produced the desired effects.
People who are obese and have major weight-related health problems, such as cardiovascular disease, type-2 diabetes, high blood pressure, etc., are advised to have this operation.
Does Health Insurance Cover Bariatric Surgery?
Yes, bariatric surgery is now covered by health insurance, provided you meet the standard criteria. According to the 2019 Insurance Regulatory and Development Authority of India, most health insurance companies cover bariatric surgery.
To guarantee coverage, reviewing the terms and conditions of the insurance that covers bariatric surgery is advisable. Bariatric surgery is only covered by health insurance policies if a patient satisfies specific requirements.
Criteria for Availing Coverage for Bariatric Surgery Under Health Insurance
- You have to be at least 18 years of age.
- The patient's body mass index (BMI) needs to be 40 or over.
- A patient is eligible for insurance coverage if their BMI falls between 35 and 40 and they have concomitant conditions like diabetes, stroke, or heart disease.
- A trained physician must recommend the operation, which must be medically essential.
- The patient must present pertinent test results and the physician's prescription.
Why Having Health Insurance for Bariatric Surgery is Important?
Obesity has become a significant global health concern, leading to an increased prevalence of various chronic diseases. Excess body fat is strongly associated with heightened risks of conditions such as type 2 diabetes, heart disease, certain cancers, and stroke.
Given such serious health conditions, here is why having health insurance for bariatric surgery is important:
Types of Bariatric Surgery Covered in Health Insurance
Bariatric surgery, commonly referred to as weight loss surgery, encompasses various types that are designed to help individuals struggling with obesity achieve weight loss. Health insurance companies offer coverage for such specific types of bariatric surgeries, which include:
Note: Insurance coverage for these procedures varies from policy to policy. Read your policy document before purchasing a health insurance policy to confirm coverage for Bariatric surgery.Â
Exclusions Under Health Insurance That Covers Bariatric Surgery
While many health insurance plans now cover bariatric surgery, there are several exclusions and limitations that policyholders should be aware of. Here are some common exclusions:
What is the Cost of Bariatric Surgery in India?
Bariatric surgery in India is expected to cost between 1 lakh and 5 lakhs(1). The cost varies depending on several factors, such as:
- The medical condition
- The city of operation
- The hospital chosen
- Post-surgery complications
- Age of patient
If someone has a medical problem that could arise before or after the surgery for connected or unrelated reasons, it could increase the cost of the surgery. Therefore, seeking insurance for weight loss surgery is a good idea before dealing with such medical concerns.
Does Bariatric Surgery Insurance Have a Waiting Period?
Yes, bariatric surgery has a waiting period for health insurance. It is typically 1-3 years, depending on your insurer and policy terms. During this time, any expenses related to bariatric surgery are not covered.
Additionally, bariatric surgery is usually covered only if it is medically necessary, such as in cases of severe obesity, with related health complications like diabetes or hypertension. It’s important to review your policy details to understand the exact waiting period and eligibility criteria for bariatric surgery coverage.
Who Should Get Health Insurance That Covers Bariatric Surgery?
Bariatric surgery is not for everyone struggling with weight issues; it is a medical intervention designed for individuals with severe obesity who have been unable to achieve sustainable weight loss through diet, exercise or other medical treatments.
Here are the key criteria for individuals who may need bariatric surgery:
What are the Risks of Delaying Bariatric Surgery?
The rising health problem of obesity impacts the majority of Indians. The World Health Organisation (WHO) reports that throughout the past forty years, the number of medical cases of obesity has tripled.
If the obese condition is not managed, one may develop other health problems such as:
- Obesity can result in Type 2 diabetes.
- Being overweight can lead to hypertension.
- Obesity can lead to poor heart health.
- If left untreated, obesity may raise blood pressure.
- Weight gain may raise cholesterol levels.
- Obesity can also result in sleeping problems.