Gastric reduction reimbursement: will my gastric reduction be reimbursed?

Are you looking into whether gastric bypass surgery can help you lose weight and become healthier?
Perhaps you are worried about the cost of gastric surgery.
Are you wondering if your health insurance company will cover the surgery?
At WeightWorks, we understand your concerns.
Our team screens people seeking gastric bypass surgery every day, and we know how important it is to get clarity on costs and reimbursement quickly.
In this blog, we explain simply and clearly when your health insurance company will cover the surgery and what the requirements are.
Agnes Bachman, financial manager at WeightWorks explains the cost if you pay for the stomach surgery treatment process yourself.

When will the health insurance company reimburse my gastric bypass surgery?

To receive reimbursement, you must meet certain rules.
These rules determine whether the surgery is necessary for your health and whether the surgery significantly improves your health.
For example, we look at your BMI (you can calculate this with the quick scan if you know your height and weight) and your physical health.

Why do insurers reimburse for gastric bypass surgery sometimes and sometimes not?

Insurers sometimes reimburse and sometimes not, depending on how important the surgery is to your health.
People with a higher BMI and serious health problems often do receive reimbursement because their health can improve greatly as a result of the surgery.
As a result, insurers are more likely to reimburse the surgery for this group.
If people gain a healthier weight and physical symptoms decrease (e.g., diabetes, high blood pressure), these people will need less care in the future.
This reduces costs for the insurer in the long run.
If you fall just outside the insurance company’s reimbursement, that doesn’t mean that gastric bypass surgery can’t be a good choice for you.
You can gain a healthier weight, fewer physical symptoms and it can have a positive impact on your body image.

What if I have to pay for it myself: How much does gastric bypass cost?

Agnes Bachman, financial manager at WeightWorks explains that of the people who sign up at WeightWorks, there is a small portion who are not reimbursed for the surgery. “Patients who choose to pay for the surgery themselves pay €9925 for it. This amount includes all screening appointments, the surgery and monitoring appointments up to one year after the surgery. The amount must be paid in advance and at least 14 days before surgery.” After the first year of monitoring, the surgeon makes a referral for the internist so that you can come for follow-up checkups in the years following surgery. These appointments do get reimbursed by the insurance company because of this referral. Reimbursement also includes appointments with the lifestyle coach and psychologist, should these be necessary. Appointments with the dietician are covered by the basic insurance, up to a maximum of 3 hours per year. You do pay your annual deductible for the care received. For more information on pricing, we have a separate pricing and reimbursement page.

If I pay myself, can I pay in installments?

No, unfortunately this is not possible.
If you pay for the surgery yourself, you will need to transfer the amount in one payment at least 14 days prior to the surgery.

Now I know more about the rules, how do I know if I am eligible for reimbursement?

We understand that you like to know where you stand when it comes to reimbursements and prices for gastric bypass surgery.
After all, you want to know if you are eligible for reimbursement, or if you will have to pay for gastric bypass surgery yourself.
At WeightWorks, we find that most people who come in for a screening get their treatment program reimbursed by their insurance company.
If you do the quick scan, you can quickly see if you may be eligible for reimbursement.
If you have any questions or doubts about whether you have to pay for the operation yourself, please contact us!