Health care costs after gastric bypass

A: Gastric bypass can be a life-saving procedure for some people. But recent medical data shows that it does not alleviate long term heath care costs. A gastric bypass patient has a significant risk of follow-up surgery for any number of complications or side effects. Gastric bypass is covered by health insurance only on a case-by-case basis. There is no presumption that this is an “ordinary and necessary medical expense” as defined by most health insurance policies. Even if the original bypass is covered by health insurance, there is a risk that some complications may not be covered. Limited medical data shows that the long term cost of providing health care to a former gastric bypass patient are two to three times the amount of an average person. That extra cost could easily exceed $100,000 over a lifetime. For this reason, most health insurance do not admit gastric bypass patients as a “standard risk” and may charge an extra premium where allowed by law to cover the additional risk. Since the implementation of a federal law known as HIPAA, you do not need to be concerned about the availability of insurance. There is now an open enrollment pan for high risk applicants in all states. Insurance is available, it is just expensive. The real problem is paying the high cost of this insurance. On average, an individual who has had gastric bypass surgery should expect to pay at least 67% more for health insurance than a preferred risk applicant. This means that if the usual rate for health insurance is $300 per month, then a former gastric bypass patient will pay $500 per month. In some states it could be much more. This becomes a major factor that must be considered in long term financial planning for a gastric bypass patient. Your health care costs - both insurance and out-of-pocket costs - will likely be your greatest expense for a long time to come.