Did you know that obesity has reached epidemic proportions on a global scale?
As per the reports of the World Health Organization (WHO), since 1975, the incidence of obesity has almost tripled. This alarming trend has resulted in over 1.9 billion adults worldwide being classified as overweight. More than 650 million of them fall under the category of obesity. In 2016, approximately 39% of adults aged 18 years and older were overweight, and 13% were classified as obese.
The consequences of this obesity epidemic are profound. It leads to a myriad of health risks ranging from-
- coronary heart disease
- stroke
- type 2 diabetes
- gallbladder disease.
This growing crisis demands urgent attention. In this blog, we will explore a specific aspect of dealing with obesity – bariatric surgeries. We will understand how health insurance whether family health insurance or cashless health insurance can play a role in making this medical intervention more accessible and affordable for those who need it.
Understanding Bariatric Surgery
Bariatric surgery is a medical procedure for weight loss and treating obesity. It involves altering the stomach and sometimes the digestive system to limit food intake and nutrient absorption.
For some individuals, bariatric surgery becomes necessary when other weight loss methods prove ineffective. Doctors typically recommend surgery for those with a-
- BMI of 40 or above, or
- BMI of 35 or more with additional health issues like sleep apnea or heart disease.
The Financial Aspect of Bariatric Surgery
Bariatric surgery costs can vary based on factors like-
- the surgical procedure
- hospital fees
- surgeon’s charges
- post-operative care expenses
It generally ranges between Rs 2.5 lakhs to Rs 5 lakhs. Concerns about affordability often deter individuals from considering bariatric surgery. This is especially for those without comprehensive health insurance or facing financial constraints.
Health insurance be it family health insurance or cashless health insurance plays a vital role in making bariatric surgery more accessible. Having the procedure covered by insurance can significantly reduce out-of-pocket expenses for patients. This can make it a more feasible option.
Important Points About Health Insurance for Bariatric Surgeries
- Following the 2019 directives of the IRDAI (Insurance Regulatory and Development Authority of India), bariatric or weight loss surgery was incorporated into the scope of medical insurance coverage.
- Health insurance can offer valuable benefits for individuals seeking bariatric surgeries. Depending on the chosen medical insurance plan, coverage may be provided if specific requirements are met.
- Health insurance companies in India now accept claims for bariatric surgery in cases of morbid obesity or co-morbidities that pose life-threatening conditions as stated in the policy.
- If a doctor deems bariatric surgery medically necessary, the insurance policy can offer compensation for the associated expenses. This change came about with the advancement of technology and new guidelines from IRDAI. These guidelines allow many insurance companies to include coverage for bariatric surgeries.
- Health insurance coverage for bariatric surgeries varies among different policies and providers. It is essential to understand what a particular insurance plan covers before proceeding with the surgery. General features of health insurance policies covering bariatric surgeries include:
- pre-and post-operative care
- hospitalisation expenses
- surgeon’s fees
- related medical costs
- To be eligible for bariatric surgery health insurance coverage, you need to meet these criteria:
- You must be at least 18 years old when getting the surgery.
- Your Body Mass Index (BMI) should be 40 or higher.
- If your BMI is 35 or higher and you have comorbidities like diabetes, heart disease, or stroke, you may also qualify.
- You must have a doctor’s prescription and relevant diagnostic test result reports to support your case.
Benefits of Health Insurance in Bariatric Surgery
Since Bariatric surgeries are expensive, so having health insurance be it family health insurance or cashless health insurance can lead to the following benefits:
- Reducing Financial Burden and Stress
Health insurance plays a vital role in easing the financial strain associated with bariatric surgery. These procedures can be expensive. Without insurance coverage, patients may face substantial out-of-pocket costs. This can cause financial stress and potential barriers to accessing treatment.
- Ensuring Access to Quality Healthcare
With health insurance coverage, individuals gain access to a broader network of healthcare providers and facilities. It ensures that they can choose experienced surgeons and reputable hospitals for their bariatric surgery. This access to quality healthcare enhances the likelihood of successful outcomes and comprehensive post-operative care.
- Empowering Individuals to Make Informed Decisions
Health insurance equips individuals with the necessary information and resources to make well-informed decisions about their bariatric surgery options. With coverage details at hand, patients can explore different treatment plans, understand costs, and collaborate with their healthcare professionals to select the most suitable course of action for their unique needs.
Conclusion
Obesity has become an epidemic, and it is the prime cause of various health risks and disorders. Bariatric surgery is a safe and easy solution to this. Bariatric surgery is a medical intervention for weight loss and obesity treatment when other methods fail. Doctors recommend bariatric surgery for individuals with a BMI of 40 or higher, or a BMI of 35 or more with additional health issues. The financial aspect of bariatric surgery can be challenging, but health insurance including family health insurance or cashless health insurance can significantly reduce out-of-pocket expenses. Health insurance coverage for bariatric surgeries varies among policies, and it is crucial to understand what is covered before proceeding.