How Does Medical Insurance Assist with Coverage for Bariatric Surgery?

Obesity has become one of the increasing concerns around the globe. Unhealthy eating habits, sedentary lifestyle, increasing reliance on processed food products are some of the reasons that contribute to obesity. A study by the ICMR-INDIAB in 2015 states that abdominal obesity is one of the major risk factors that contribute to cardiovascular diseases. This study also reported that obesity among women is higher as compared to their male counterparts.

What is a bariatric surgery?

A more serious form of obesity can even pose risk to health and might require undergoing a surgery. This procedure is known as bariatric surgery where doctors recommend it only after standard weight-loss measures like dieting, routine and rigorous exercise have all failed.

Who needs to undergo bariatric surgery?

At present, medical professionals follow three-decade-old criteria where the body mass index (BMI) of a person is 40 or higher. Or, have a BMI of 35 or more but also life-threatening ailments like type 2 diabetes, high blood pressure, heart disease, or even sleep apnoea. Nevertheless, many doctors are of the opinion that lowering the BMI criteria to 30 can be helpful for people with the above-mentioned fatal ailments. Many patients resort to bariatric surgery as a crutch to lose weight instead of choosing the healthy lifestyle and good dietary practices and they end up gaining weight soon after the surgery.

Is there a specific procedure to undergo bariatric surgery?

Yes, bariatric surgery requires the patient to follow a rigorous diet plan with exercise as part of your routine life—all of it to avoid weight gain again. However, it is a safe alternative for critical cases where all other measures have failed.

Does medical insurance provide coverage for bariatric surgery?

The type of health insurance policy, i.e., health insurance plans for family or individual covers determines what is covered by the policy or not. Generally, most insurance companies accept claims for such bariatric treatment however, you must check your medical insurance policy’s scope. The bariatric treatment is expensive, and its costs lie in the range of ₹2.5 lakhs to ₹5 lakhs. It is also dependent on factors like type of surgery, severity of the treatment, surgeons fee, the medical facility selected, instruments used, consultants on-board, anaesthesia and other follow-up procedures. To tackle such high cost of treatment, it is best to make an insurance claim with your insurer that takes care of all these costs within having to focus on recovery more than worrying about the finances. * Standard T&C Apply

Are there any exclusions to the coverage for bariatric treatment?

Like any health insurance policy, the coverage offered for the treatment is limited subject to terms and condition of the insurance plan. Any claims for bariatric treatment during the initial waiting period of 30 days for your health insurance policy are rejected by the insurer. Also, claims for any pre-existing conditions are not covered under such treatment. * Standard T&C Apply While bariatric treatment is the last stage effort to deal with obesity, it is an effective way to avoid a fatality due to such ailment. Hence it is a useful way to get health back on track. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.