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How do you know if you qualify for Weight Loss Surgery and What Insurance Companies Cover Weight Loss Surgery?

The pains that come with undergoing a medical procedure are quite much. It is not commendable when the patient actually went for a procedure that he does not qualify for. The number of obese people is on the increase in the United Kingdom (UK) and some other constituent countries of Europe.

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Hundreds fly abroad from the UK each year to Weight Loss Riga for weight loss surgery.

Many patients prefer embarking on medical tourism to staying back for a weight loss surgery. However, there are restrictions on the procedure. Sometimes, a supposed “patient” is not in a good position to undergo the operation.

It is worth noting that not everyone is a good candidate for bariatric surgery. The procedure entails the reduction of the stomach. After that, food digestion is faster as the individual only has a little portion to fill in his stomach. Going through the knife is the last resort after exploring other weight loss channels.

Patients that scale the sledgehammer of bariatric surgery qualification have another hurdle to face – funding. Not all weight loss surgery candidates are financially buoyant to foot the bills. In the light of this, they turn to third-party funders like insurance companies. This is also another hurdle in the weight loss journey of a patient. Most times, insurance applications do not see daylight. To this end, we’ll be looking at the requirements for bariatric surgery and the underlying perceptions of insurance companies that cover the procedure.

The Qualification Process

In Europe, individuals that want to go through the knife to shed off extra kilos of flesh rely on the dictates of their surgeons. But before that, the GP has to give the nod. In some scenarios, the buck stops at the GP’s table as any application that does not get his approval cannot move to the next stage. This means that the process of qualification is not easy to come by. The perception that only morbidly-obese individuals are in a better position to get a weight loss surgery is wrong. Sometimes, an individual that is seemingly in a better position is not given permission to undergo the surgery. So what qualifies you for a weight loss surgery?

    • Body Mass Index (BMI): The first phase of qualification is meeting the BMI requirements. The Body Mass Index (BMI) is the numerical value of your weight. This is in relation to your height. Before the surgery, the surgeon considers the relationship between your height and weight. In some cases, the patient does not get the nod. The BMI differs by the specific procedure. Also, some clinics have guidelines for this. In a conventional setting, a BMI of 30-39 qualifies an individual for the surgery. An individual is morbidly obese when his BMI is within the corridors of 40. However, this is not an accurate way of qualification. There are instances when comorbidities can influence the surgical operation. But generally, a BMI from 30 and above qualifies for the procedure.
    • Patients’ Health: Another step to qualifying for a weight loss surgery is the stability of the patients’ health. For instance, the patient should be able to handle the physical changes in the procedure and also healthy enough to tolerate the surgery.
    • Patients’ Lifestyle: A patient that smokes is given consideration than another that does not. The lifestyle of obese individual counts in the qualification process for a weight loss surgery. When left for long, there is a tendency that the situation might degenerate to a severe medical condition.
    • Comorbidities: Being obese comes with severe health challenges. There are instances where patients’ lives are in the line of danger. The tendency to develop heart disease is likely for such individuals. A patient that is obese and has life-shortening diseases such as sleep apnea and diabetes gets immediate approval to undergo a weight loss surgical operation. Also, the odds will be in the patients’ favor if the surgery will take off these diseases and improve his lifespan.
    • Age: Age is another factor that qualifies you for bariatric surgery. It is not out of place for a younger patient to get the nod instead of an older individual. On the other hand, older patients can get faster approval if their health is failing. Normally, an individual that is under the age of 65 qualifies for the surgery.
    • Motivation: It is common to have patients being skeptical of going through the knife. The surgeon finds out if you’re motivated to lose weight and lead a healthy lifestyle after the surgery. The patient should also understand the risks and be able to adjust eating habits after the operation.
    • Weight Loss History: It might sound out of place but many patients have been trying their hands on other methods before settling for bariatric surgery. Before the procedure became popular, healthy dieting and regular exercises are faster ways to shed off extra flesh. A patient’s weight loss history counts in the qualification process. In a traditional clime, an obese individual must have made attempts to lose for the past two (2) years. However, note that this is not applicable in the private medical sector. Find out the number of attempts that qualifies for the procedure before taking the decision of undergoing a weight loss surgery.
  • Exceptions: It is wrong to assume only adults qualify for the surgical operation. Adolescents also qualify if their health is at risk.

Pre-Surgery Requirements

The pre-surgery requirements for a bariatric procedure vary by clinics. For instance, if you’re footing the bills, you have to conform to the clinic’s requirements. But if you’re looking at getting a nod from the NHS, there are certain stipulations you have to meet. It is important to note that the requirements in spotlight are not relevant in the private medical sector. You should be looking at getting them under the NHS scheme.

It would interest you to know that the surgeon’s evaluation is not the last lap to get a weight loss surgery. Sometimes, the patient shoots himself in the foot. This is the case when an obese individual fails to secure the surgeon’s trust during the pre-surgical process. After a patient has been given the nod for a surgical operation, he is taken through a “sample” of his lifestyle after the procedure. During the pre-surgical operation stage, there are guidelines to go through. Most of the requirements that were examined before the approval are revisited. The health care team issues instructions on preparations for the weeks before the surgery.

Among these are supervisions in dieting and constant checkup in exercises. Also, the patient’ lifestyle and habits such as smoking and alcohol intake be under scrutiny. To make the surgery less strenuous, the health team sometimes requires the patient to lose some kilos of flesh before the surgical operation. Even after these requirements are met, the surgery can be canceled. If you’re wondering how possible this can be, here are some reasons why a weight loss surgery can be put off for some time:

    • Weight Gain: Some patients that are food addicts cannot make it to the “finals”. There is a tendency that weight gain will become the case during the pre-op stage. Gaining weight instead of shedding off an extra kilo of flesh is a big turn-off and can cost you the surgical operation.
    • Inadequate Motivation: It is important to have the right attitude throughout the process. Putting up signs of low self-esteem or not being in a good frame of mind is another reason the surgery can flop.
  • Non-Conformity to Lifestyle Change: Inability to stick to a good lifestyle is commensurate to “no surgery”. If you were not able to put up a healthy lifestyle during the pre-op stage, it is a clear indication that you might not be able to brace the challenges of the post-op stage. Patients are disqualified when they do not make positive changes in their exercising and eating habits.

Funding the Surgery

The pain of losing out in the qualification process pushes obese individuals to the edge. They put up efforts to scale the stage. After that, the next challenge is funding the procedure. If it’s determined that weight loss surgery is appropriate for you, your next step is making financial plans. There are many options to choose from. You can go on self-funding or require insurance approval. Funding the procedure yourself might dip a hole in your pocket. That is the reason why many obese patients seek insurance for weight loss surgery. Luckily, there are many insurance companies offering coverage for bariatric surgery. However, you need to prove yourself worthy of the coverage before funds are made accessible to you.

What you should know about Insurance Companies

Different insurance companies have guidelines for obese individuals that want coverage for their weight loss surgical operations. For instance, the company tends to have different requirements than most clinics. In the light of this, it is important to find out the requirements of your insurance company before tendering your application. Also, the National Health Service (NHS) is a good place to turn to for funds. It is important to understand the guidelines each of these institutions present before settling for them.

Insurance Companies and Coverage

If you’ve chosen weight loss surgery as the best option to shed off extra kilos of flesh, it is important to get your insurance company aware of the situation. In the UK, the National Health Service (NHS) offers coverage on bariatric surgeries. With the service, you save some money and obtain better healthcare. With the NHS, an obese individual can get access to bariatric surgery within the constituent countries of Europe.

As weight loss surgery is on the rise, insurance companies are already taking the cue to offer their services to patients. In the light of this, you can register with a private insurer ahead of time. It is worth noting that the stipulations differ. Find out if the company has guidelines that are favorable to you. Also, find out the amount they’re willing to pay for the coverage.

The Costs Also Count

The overall essence of seeking out insurer’s service is to reduce the cost you will spend during the procedure. On the contrary, the insurance company does not take off every financial expense from your budget. The patient has to pay some bills during and after the procedure. Without the input of health insurance from these companies, bariatric surgery can be costly. It is always in the patient’s benefit to register and get his insurance from the National Health Service (NHS). If that is not successful, brace up to pay for some other services that private insurers do not support. If you’re looking at private insurance companies to fund your weight loss surgery, here are some fees you will be saving:

    • Physician Consultations: Before the surgical operation, you have to meet with the medical team. The fees that are accruable to this service are among the insurance coverage you will be getting with a private healthcare insurer. The coverage will also cover the post-operation fees; especially consultations with the doctor.
  • Accommodation: Sometimes, the insurance company knocks some bit of finance from your budget by helping out with the patients’ accommodation. This can be in the clinic or a hotel where the patient retires for some time after the operation.

Aside the bills an insurance company foots, an obese individual that is set for a weight loss operation ought to have funds for out-of-the-pocket expenses.

The Insurance Company might back off

As much as insurance companies are willing to help obese individuals pay off their bills, get access to quality healthcare services and lead a healthy lifestyle after a weight loss surgery, there are times when they can withdraw their services.

Your surgeon might declare you a candidate for the procedure but the insurer could think otherwise. They tend to look at several aspects to your doctor’s report before taking on your bills. While the surgeon is willing to proceed with the procedure, the insurance company might refuse to foot the bills. This is usually the case when patients do not meet up to the insurer’s requirements. The insurer can back off for some reasons such as the inability of the patient to meet up with his percentage of the bill. To stop this occurrence, it is important to find out the conditions on time.

You can qualify for Weight Loss Surgery

Every year, hundreds of obese individuals undergo bariatric surgery in choice clinics in Europe. Weight Loss Riga tops the list of clinics in the European region that offer safe bariatric surgeries. You can qualify for the procedure when you meet up with the requirements. Also, find out the underlying options in your insurer’s coverage. This lets you make alternate arrangements, if possible. When it comes to weight loss surgery, you have lots of options to pick from and Weight Loss Riga is here to help you make the right decision in your long-term weight loss goals.