If you are struggling with your weight, chances are, you feel frustrated. You want to live a lifestyle that is healthy and active, but sometimes the pounds simply prevent you from doing that. Weight loss surgery is one great option, especially when paired with a healthier diet and increased physical activity.
Turning to bariatric surgery to lose weight is a big decision, especially if you’re retired and living on a fixed income. While insurance companies are covering weight-loss surgery more often because of the health benefits, you may be relying on Medicare coverage for health benefits.
Medicare and Weight Loss Surgery
Medicare covers weight loss surgery in many cases, including roux en y gastric bypass, duodenal switch, and lap band surgery. Any other weight loss procedures are deemed experimental and will not be covered by Medicare. Some of these might include a gastric balloon, intestinal bypass, or liposuction.
However, you must meet specific coverage requirement, including:
- Body mass index (BMI) of 35 or greater
- Passed psychological evaluation
- An illness that is directly related to obesity (examples: high blood pressure, diabetes, etc.)
- Documented evidence of obesity for the last five consecutive years
- Proof of medically supervised weight loss program completion or nutritional counseling (you must show that you’ve tried other avenues of weight loss)
- A physician’s letter supporting or recommending weight loss surgery
- Normal screening tests that prove that there are no other medical issues that are causing your obesity
Medicare looks at each case uniquely. You must be able to provide the scientific facts of your obesity, in addition to the documentation that you’ve met the other Medicare requirements. It may take a few months to get all of these things in order and to get an answer from Medicare to see if you have been approved.
It’s important to note that specific coverage depends on which type of Medicare plan you are currently enrolled in. For example, Original Medicare includes both Parts A and B and covers doctor visits, hospital stays, skilled nursing care, durable medical equipment, and other services.
Part C, otherwise known as Medicare Advantage, covers much of Original Medicare while providing certain additional benefits. Prescription drug coverage is included in Medicare Part D. Other types of insurance include Medicare Supplemental (or Medigap) Plans and are used to cover health care procedures not covered by other areas of Medicare.
Weight loss surgeries cost anywhere from a few thousand dollars to more than $15,000. On a fixed income, that’s a lot of out of pocket expenses. However, if professional medical advice points to bariatric surgery to improve your quality of life, Medicare, private insurance, or a combination of the two may help.
The WeightWise Program
At this point, WeightWise surgeons don’t work with Medicare, although the hospital stay and anesthesia are covered by Medicare in most cases. When you partner with WeightWise on your weight-loss journey, every aspect of the procedure will be covered. Our patient advocates will answer all of your financial questions, including what your current health care insurance benefits include, as well as helping schedule appointments and other information.
The mental aspects of the program are just as important as the physical changes you’ll be going through. Think of your patient advocates as your personal cheerleader – rooting on your success and being a sympathetic ear during the tough times.
WeightWise will also provide you with in-house professional dietitians and exercise physiologists to map out successful long-term weight loss. The first few weeks after surgery are the most important for many patients. Which makes sense – that’s the case with any major life-changing event.
During the first two weeks after surgery, you will be limited to an all-clear liquid diet, as well as protein supplements or protein shakes. You will be expected to drink 96 ounces a day – a daunting amount of you’re normally drinking just a third of that.
Staying hydrated is very important during this time, but the liquid must NOT be gulped. In many cases, your stomach is now one-fifth the size. It just won’t be able to handle large quantities of liquid at one time. It could lead to nausea, pain, or even injury.
During these 14 days, your body will begin to adapt to less food intake. Hormonal changes will allow you to feel “satisfied” sooner and lead to reduced hunger pangs. In the following weeks and months, vitamins and minerals, soft foods, and solid foods will be introduced.
Of course, certain foods are no longer allowed. Worried that you’ll be stuck eating celery the rest of your life? Don’t be! WeightWise has compiled hundreds of delicious recipes and our shop is jam-packed with tasty treats, meals, and snacks. You eat better than you ever have before!
Not sure if weight loss surgery is right for you? Call our experienced and compassionate team at WeightWise. We look forward to helping you start your weight loss journey!
Although you’ll be able to return to normal day-to-day activities 24-48 hours after surgery, you’ll still need time to heal. Our exercise physiologist will develop plans that take into any previous injuries, your current fitness, and other aspects of your life. These programs will increase flexibility and improve your cardiovascular health.
Once you’ve reached your target weight, usually between nine and 12 months, weight-training will be introduced. You should be exercising at least 30 minutes a day, five times a week at this point. We’ll work with your physician to make sure our plans are the perfect fit for you.
Watch our free online seminar to see why our program has been so successful for so many people. When you’re ready to take the first step towards leading a longer, healthier life, make sure to reach out to WeightWise. We’ll be here for you – every step of the way.