How Much Does Gastric Sleeve Surgery Cost?
Anyone who deals with obesity knows that the weight loss journey can be a difficult one. For those with a body mass index (BMI) over 35, this excess weight can be a contributing factor in many other health issues. Therefore, your doctor may recommend gastric sleeve surgery. In this article, we’ll discuss what gastric sleeve surgery is, why you may opt to get it, and the costs of having this procedure. To start, let’s answer the question: What is gastric sleeve surgery?
What is gastric sleeve surgery?
Gastric sleeve surgery is a type of bariatric surgery, which is a weight loss surgery. Sometimes you’ll hear it referred to as a sleeve gastrectomy or a vertical sleeve gastrectomy. During the surgery, a surgeon makes incisions and reduces the size of the stomach, helping to decrease its size by up to 80%. The surgeon then combines the remaining parts of the stomach to form a sleeve-like shape that resembles a banana.
Because of this reduction of the stomach, patients feel full faster, limit overall food intake, and lose weight. While the procedure can help those with high BMI, it may also help treat conditions related to obesity, such as high blood pressure, heart disease, fatty liver disease, sleep apnea, and type 2 diabetes.
Gastric sleeve surgery is generally seen as less invasive than other bariatric surgery procedures, such as gastric bypass or gastric banding. If gastric sleeve surgery is recommended to you by a medical professional, it’s important to understand the potential positives and challenges of the surgery.
Weighing the benefits and risks of gastric sleeve surgery
For those who are contemplating a gastric sleeve surgery, be sure to account for the benefits and risks of the surgery. While the benefits of a weight loss procedure outweigh the risks for many, this is a personal decision, and you should have all the information before making a decision. Here are the key benefits:
- Expected weight loss: Those who have successful gastric sleeve surgery experience weight loss that can improve their quality of life.
- Improved health outcomes: Many who have gastric sleeve surgery can lower the severity of their obesity-related health conditions or resolve them completely.
- Financial savings: Obesity can be expensive, especially when you factor in the additional medical bills of treating comorbidities of obesity. Improved health also comes with a lessened medical financial strain.
So, what are the risks of gastric sleeve surgery? The potential risks of the procedure include:
- Surgical complications: These complications are present in any surgery environment but include infection, bleeding, and other complications
- Lifestyle changes required: Any bariatric surgery requires a lifestyle change to maintain the results. Dietary changes and shifts in exercise patterns are required to keep the weight off. There is no guarantee that you’ll maintain your weight after having this procedure.
The costs of gastric sleeve surgery
According to Bariatric Surgery Source, the average cost for gastric sleeve surgery in the United States is just over $19,000. However, these costs can vary widely based on where you have the procedure performed, where you live, and more. Here are some of the biggest factors that can influence the total cost of gastric sleeve surgery:
- Geographic location: Costs for any surgical procedure can vary based on the location of the surgery. In some high-cost-of-living areas, costs may be higher than in lower-cost-of-living areas. However, if you live in a rural area, your costs may also be higher because of the lack of providers.
- Bariatric surgeon fees: The more experienced your medical provider is, the more they may charge. These fees are an important consideration for the total cost of surgery.
- Hospital or surgery center fees: Whether you have the procedure performed in a hospital or surgery center can also significantly affect your total cost.
- Pre-operative tests: The number of pre-op tests you may need can also increase the cost of your procedure.
- Anesthesia: Many surgical procedures require anesthesia, and gastric sleeve surgery is no exception. The cost of anesthesia can vary depending on several factors.
- Post-surgery care: Based on the time you’ll need to recover, you may incur post-surgery care fees from hospital stays or at-home care.
- Hidden costs: These hidden costs can add up, especially if you plan to travel for the procedure. From travel expenses to follow-up care appointment costs, lifestyle changes, loss of work during recovery, and more, there are many hidden costs you should keep in mind when planning for gastric sleeve surgery.
- Insurance coverage: While many insurance providers will pay for some or all of the costs of surgery, your specific coverage directly affects your total out-of-pocket expenses. As you navigate your insurance coverage, you must understand the deductibles, copays, or coinsurance costs you may be responsible for.
- Skin removal: After a successful gastric sleeve surgery, you may decide to get skin removal surgery. This is a cosmetic surgery that you may or may not decide to do.
As you can see, costs for bariatric gastric sleeve surgery can add up. But there are ways you can lower your or a loved one’s total cost for surgery.
Crowdfunding for gastric sleeve surgery
One way to get help for your gastric sleeve surgery is to utilize a crowdfunding platform like GoFundMe. Whether you need to fill the financial gaps between the total cost of surgery and your insurance coverage, or you need financial help to pay for the entire operation out-of-pocket, GoFundMe is a great place to start. Get a fundraiser started in just a few minutes, for free. Plus, access the help you need without long waiting periods to get your funds. With GoFundMe, you can start getting the help you need for yourself, a friend, or a loved one.
Does insurance cover gastric sleeve surgery?
With any surgical procedure, insurance can help pay for some or all of the costs. Again, this depends on your insurance type and coverage. You may have insurance through a private company or through a government health plan. Here’s what you need to know about coverage for gastric sleeve surgery.
Private health care coverage
Individuals who get insurance through their employer are familiar with this type of insurance coverage. In private health care coverage, an insurance company provides an entire group or organization with coverage. Sometimes, your employer will pay for part of this coverage. You can also access private health care coverage through a provider directly or through the Health Care Marketplace.
Many leading private insurance companies will cover bariatric surgeries, although many of them have certain conditions that need to be met before deeming weight-loss surgery to be medically necessary. Some of these conditions may include:
- A body mass index of 40 or more or a BMI of 35 or higher with an obesity-related condition
- Documentation of active participation in a previous weight loss program
- Documentation of pre-operative medical and mental health evaluations
- Pre-operative nutritional counseling with a registered dietitian
These are just a few examples of what your insurance provider may require, but plans and providers vary. Therefore, it’s crucial that you review your plan documents and discover what’s required for your coverage. For more information on your specific coverages, contact your insurance company directly.
Government health insurance plans
Another common type of insurance plan is a government health plan, which includes Medicare or Medicaid coverage.
Medicare
Medicare is insurance for those people over the age of 65, those with disabilities, or those with certain diseases. Medicare plans go through private companies that contract with Medicare to offer coverage. There are four main components of Medicare plans: hospital insurance (Part A), medical insurance (Part B), Medicare Advantage Plans (Part C), and prescription drug coverage (Part D). In addition, there are also Medicare Cost Plans and the Program of All-inclusive Care for the Elderly (PACE).
While it’s difficult to estimate the costs of your procedures before services are rendered, Medicare will cover some of the costs of bariatric surgeries that are medically necessary. If you elect to have surgery at an inpatient hospital, Medicare Part A helps to cover the costs. If you decide to have surgery at an outpatient center, Medicare Part B helps to cover the costs.
Medicaid
Medicaid is a state and federal program that helps cover medical costs for those with limited income and resources. Each state runs its own Medicaid program, following the general rules set forth by the federal government. Generally, Medicaid covers some portion of medically necessary gastric sleeve surgeries. However, because each state is different, they may have other coverage requirements for bariatric surgeries. Contact your state to learn more about Medicaid eligibility and your coverage options.
For those without medical insurance, you may have to pay the entire cost out of your own pocket. However, there are some options to finance gastric sleeve surgery without insurance.
Financing surgery without insurance
There are a few ways to finance the cost of weight loss surgery without using insurance. Here are a few ways to pay:
- Self-payment: If you can afford the total out-of-pocket amount, you may be able to negotiate a price for self-pay surgery. Outpatient centers may be the best option for this, as they tend to be less expensive than hospital surgery centers.
- Payment plans: Some healthcare systems offer payment plans. These payment plans offer a fixed monthly payment amount that allows you to pay for the cost of your procedure in monthly installments. Healthcare payment plans tend to have zero or low-interest terms, saving you money on interest fees compared to other financing options.
- Medical credit cards: These credit cards are specifically designed for medical procedures. While they can offer you a short-term solution and generous introductory interest rates, it’s important to be realistic about when you’ll be able to pay off these credit cards. Keep in mind that the longer you hold onto the debt, the more you’ll be paying toward interest fees, especially after the introductory rates expire.
- Financial assistance programs: Some nonprofit organizations offer financial assistance for medical procedures. One such organization is the Weight Loss Surgery Foundation of America, which offers financial grants to help pay for bariatric surgeries.
Having a gastric sleeve procedure can be life-changing for many. However, finances are an important component of the entire picture. For those whose biggest barrier to getting gastric sleeve surgery is a financial one, GoFundMe can help. As a leading crowdfunding platform, we’ve helped people all over the country get the help they need for surgeries like gastric sleeve surgery. So if now is the time to ask for help, get one step closer to gastric sleeve surgery by starting a fundraiser with GoFundMe.