Need to go for a weight loss surgery and are wondering if your health insurance policy will cover it or not then you are at the right place. Amid the rising cases of obesity, a lot of people are opting for Bariatric surgeries as an alternative for losing weight. When exercising, dieting; and gym fail nowadays a few people opt for this procedure as well.
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Let’s understand what is bariatric surgery or weight loss surgery and how health insurance can help. Last year in October 2019, as per the IRDAI’s (Insurance Regulatory and Development Authority of India) guidelines, bariatric or weight loss surgery was included under medical insurance cover. The move was to ensure coverage to obese people suffering from co-morbidities related. With this inclusion in both family health insurance plans and individual health plans or even a critical illness policy, nearly 38% people were expected to benefit in the rural areas ad 30% urban population of India.
Moreover, you can easily search for it on our site and buy health insurance online in just a few clicks. But before that let’s read some important details regarding the whole procedure.
People who are overweight and have a greater BMI even after walking and working out, losing weight can get challenging for them. Once a doctor advises bariatric surgery to an obese person to avoid any medical issues in future, it shall be covered in a health insurance policy that covers bariatric procedures. It is a safe procedure that aids in weight-loss and helps in shedding of the excess weight.
Bariatric surgery is recommended to those who have a Body Mass Index (BMI) of 40 or above. People, suffering from obesity and serious weight-related health issues like cardiovascular illnesses, Type-2 diabetes, high blood pressure, sleep apnea, etc. are suggested this surgery.
The patient needs to follow a certain diet plan before undergoing the bariatric surgery, followed by exercise to avoid post-surgery weight gain. Though bariatric surgery is a safe alternative to lose weight but there are certain risks involved as well including infections, blood clotting in the lungs, and internal bleeding.
A bariatric surgical procedure can cost around Rs. 2.5 Lakh to Rs 5 Lakh and the cost would depend on other factors including the type of surgery, hospital, gastroenterology surgeon’s fees, etc. other additional costs would include the cost of surgical instruments, anaesthesia, and follow-up procedures.
Obesity-related health issues that are resolved after the surgery:
Medical insurance can cover the following surgical procedures:
After the procedures, one's ability to eat is restricted, thereby causing weight loss. After the surgery, the person has a smaller stomach that can only hold a few ounces. Additionally, some weight-loss surgeries limit the absorption of nutrients and calories. If you are undergoing the procedure you will also need to take part in nutrition and behavior classes to help you with post-surgery life.
Health insurance now covers bariatric surgery if you meet requirements. The coverage depends on the medical insurance plan selected by you. Health insurance companies in India accept the claims for morbid obesity or co-morbidities or life-threatening conditions as mentioned in the policy. If the doctor advises bariatric surgery you can get compensation for the expenses. Generally, you need to furnish the proof to the insurer that the surgery is medically essential.
Until 2019, bariatric surgery was a standard exclusion in mediclaim policies. However, with technological advancements and new IRDAI guidelines, many insurance companies pay for bariatric surgery. However, the benefit is only available if it’s medically necessary and is not being used for cosmetic purposes.
The waiting period in health insurance applies to bariatric surgical procedures and ranges from 2 to 4 years. So, if you want to claim your bariatric surgery expenses then you can do so after the completion of the waiting period post-policy purchase.
Whether it is covered in a critical illness policy or a family health insurance plan, following exclusions apply to Bariatric Surgical procedures:
The best way to avail health insurance benefits for bariatric surgery is by doing proper research before buying health insurance online.
When filing claims for bariatric surgery under your health insurance policy you need to meet the following conditions and submit the below-mentioned documents:
Expenses incurred on Bariatric Surgery are usually not covered in a basic medical insurance policy. However, insurers nowadays offer an option to get Bariatric Surgery Insurance as an add-on cover by paying a little extra premium. All you need to do is do some research on your end if you would need to pay extra in your health insurance policy, or the whole expenses are covered, as it would vary from insurer plan to another and from one insurer to another.
Coverage for bariatric surgeries is a fresh take at how medical insurance in India is gradually becoming more customer-friendly, by offering personalized and extensive coverage benefits.
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