Is Gastric Balloon Covered by Insurance?

Spatz3 is the world’s only Adjustable Gastric Balloon System

Gastric balloons are non-surgical and helpful interventions for individuals who have a BMI of 30 or higher (the minimum BMI varies depending on the country). Gastric balloons are shown to help people lose an average 22-66 pounds depending on the patient and their compliance with the plan they and their doctor come up with. Despite the fact that gastric balloons can help reduce obesity and health-related comorbidities associated with obesity, gastric balloons are not covered by insurance.

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How Much Does a Gastric Balloon Cost

The reasons for insurance not covering gastric balloon procedures vary, but it appears from research that many insurance companies have not conducted further research into the safety and efficacy of the gastric balloon procedure. While other more invasive and risky bariatric procedures and surgeries are covered, it suggests that there will come a time the gastric balloon is covered by insurance.

Of course, it’s not possible to know when that will transpire. Presently, gastric balloons are the lowest-costing therapies for weight reduction, and gastric balloons are the least invasive.

Depending on where you are in the world, the procedure typically costs between $6,000 and $9,000.

There are new approaches to gastric balloon therapies such as the Spatz3 Adjustable Gastric Balloon, which can be increased or decreased in volume depending on the patient’s specific needs. The adjustment factor has helped the adjustable balloon achieve results and overcome issues related to long-term weight maintenance and to gastric balloon intolerance confronted in the past.

Is Gastric Balloon Covered by Insurance

Is a Gastric Balloon Worth It?

Thus, one can argue that the gastric balloon is worth it. This option is available for individuals who are:

  • Dedicated and ready to do the work it takes to make lifestyle changes for permanent weight loss and management, and
  • Out of options regarding weight loss management

For patients who fit these criteria, this non-surgical bariatric solution is a blessing. While no procedure is complication-free, the gastric balloon has fewer risks than other, more costly alternatives, which also are not or are either only partially covered by insurance.

Thus, for people who qualify, the lifestyle investment afforded by a gastric balloon is well worth the cost and makes wondering whether or not it’s covered by insurance moot as it’s a necessity, not a luxury.

How to Pay for a Gastric Balloon

Despite the gastric balloon being a necessity for people who have tried to lose weight in other ways and who are dedicated but who still cannot do so without help, as noted, insurance presently does not cover the procedure (though, it is worth contacting your insurance company to ask if they offer any kind of coverage for a gastric balloon).

There are financing options. Ask the doctor and organization doing your surgery who they recommend (if anyone) and also conduct a Google search to find a company that finances bariatric surgery. You’ll be able to pay for the procedure and set up a payment plan.

Medical loans are also available to help you pay for your gastric balloon if you decide it’s the right choice for you. An additional financial loophole is that you might be able to get tax deductions and special doctor-specific discounts, so don’t hesitate to inquire about that as well when you speak with your doctor.

People who have financed procedures like this reportedly do not regret their choices. They are thrilled with their outcomes and consider it worth it. After all, the balloon can be inserted in less than half an hour. Within six months, people drop an average of 30% of their excess body weight. There are many positives.

Further, people who respond well to the gastric balloon tend to maintain their new dietary habits once the device is removed, leading to lifelong health benefits.

Thus, even though the gastric balloon is not covered by insurance as of February 2022, it’s a worthy investment for your health, longevity, confidence, and livelihood that you deserve to have and that you should explore.

Hopefully there will come a time when gastric balloons are covered by insurance. Until then, there are financing options, and doctors are happy to help you find a way to have a non-surgical procedure to improve your quality of life. Contact us at Spatz Medical today and let us know about you to determine if you qualify for a gastric balloon.

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