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Health Insurance for Bariatric Surgery in India

Published On Dec 23, 2020 5:30 AM By Gunjan Anand

Although, an individual can overcome obesity naturally by following a healthy diet and regular workout. However, due to certain medical conditions some people face extreme difficulties in shedding their extra weight. During such situations, bariatric surgery can be considered as a better solution to the given problem. Many health insurance companies now provide a benefit for Bariatric Surgery, or an individual can also avail Insurance for Bariatric surgery along with their health insurance .

What Do You Mean by Bariatric Surgery?

Some years ago, Premnath was in a miserable condition owing to his heavy frame of 150 Kg. He was unable to perform regular activities such as climbing the stairs or walk around the house for any other activity. However, Premanath found an incredible solution to his problem and now he weighs much lesser than what he used to earlier.
This happened all because of Bariatric Surgery that he opted for on advice of his doctor. Simply speaking, Bariatric surgery is a surgery designed to lose excess weight safely.

Health Insurance for Bariatric Surgery in India

How Health Insurance Assist in Bariatric Surgery?

The Bariatric Surgery coverage is dependent upon the type of policy chosen by the individual. Almost many insurance providers accept claims for the treatment of obesity that is life-threatening. Insurance Regulatory and Development Authority of India has proposed all insurance providers to offer coverage for Bariatric Surgery in all the group as well as retail health products. Cover for such surgeries need to meet set criterias that are mentioned below:

Who Requires Bariatric Surgery Insurance?

Bariatric surgery insurance is suitable for individuals who are obese and weigh more than 100 Kg or more. Moreover, if any of the family members had obesity or a family history of obesity and even for people who are intended to gain weight in a short amount of time.

What are the Conditions to Cover Bariatric Surgery?

If you want your insurer to provide coverage for bariatric surgery, all the below mentioned conditions must be fulfilled:

  • Your doctor must advise you for surgery.
  • Body Mass Index should be greater than 40.
  • Body Mass Index should be greater than or equal to 35, and should suffer from other concurrent diseases like sleep apnea, liver diseases, coronary heart diseases etc.
  • Insured members undergoing surgery should be more than 18 years or more in age.
  • The surgery should be backed up by all the diagnostic and medical testing.

What All Expenses are Covered Under Health Insurance Policy Other Than the Cost for Weight Loss Surgery?

Surgery is not a standalone process and has to be preceded by certain tests like blood work, MRI, etc. Health care procedures such as pre operative and post operative care are equally important. Generally, an insurance company offers 30 days of pre-hospitalisation expenses like medication, doctor’s fees,
diagnostic tests etc and 60 days of post-hospitalisation expenses. Which include follow-ups, medication etc.

Does Bariatric Surgery Insurance have a Waiting Period?

Yes, dependent upon the insurance company, bariatric surgery generally has a waiting period of 2-4 years. To simplify, in order for you to cover bariatric surgery under your health insurance plan, you are required to wait for 2 years from the beginning of your health plan.

What are the Documents required to Avail of Bariatric Surgery under Health Insurance?

You are required to submit a detailed report of past obesity related health concerns, other problems and attempts at the treatment. Any pharmacological therapy that had not worked in the past 6 months of the treatment.

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Take Away

Claims with existing conditions and ones that arise within the 30 days of commencement of a health insurance plan are not covered. Therefore, in order to avail of the benefits of bariatric surgery, proper research needs to be done by you prior to selecting a health insurance plan.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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