Gastric Bypass Surgery Not Covered By Insurance

Reporter: Shannon Samson

Web Producer: Amber Griswold

Indiana law requires state health plans to cover gastric bypass surgery for morbidly obese patients. But it's only an option with private insurance companies, and that's leaving some employees wondering what to do.
Some reasons employers may be choosing not to purchase the option of offering surgical weight loss: each gastric bypass procedure costs around 30-thousand dollars which may lead to higher premiums for every employee. Plus, the surgery has its share of complications, three out of every one thousand patients die.
Vicki Woods can play with her three kids without getting winded now that she's 150 pounds lighter, thanks to gastric bypass surgery two years ago. Her insurance company paid for it.
Vicki explained where she would be today, had her insurance not covered her surgery. "I would still be 300 pounds. There's no way I could have afforded to have it done."

That's the situation one Evansville man who wants to remain anonymous finds himself in. His employer, American General, chose not to purchase the option offered by Welborn Health Plans. Just this year, the HMO decided to drop gastric bypass surgery from its base plan, in what a company spokesperson calls a direct effort to lower employer health care costs.

Vicki says it's a trend that's increasing. She says she doesn't see it as a coincidence, that now that gastric bypass is offered in Evansville and more people want it, that more insurance companies and employers won't pay for it. Several of the people she counsels, in The Surgical Weight Loss Support Group she co-founded, are finding themselves scrambling to find a way to pay for the surgery out-of-pocket. She's always told them not to give up on insurance.
"Go to your company that you work for and talk to them. They're really the ones in control of what services can be covered. If it's that they're wanting more information, it maybe that the paperwork wasn't complete. Whenever you get a denial, it doesn't always mean this is the end."
Vicki Woods said attorneys who help patients persuade their insurance companies and employers to cover gastric bypass surgery can be contacted at

She also encourages people to come to her support group for help. It meets every third Wednesday of each month at 6:30 P.M., Deaconess Hospital Health Science Building, Edgar Street Room 104A. Vicki can be contacted at for more information.

For Vicki, gastric bypass was only the beginning of a better life, "I don't have any excuses anymore, not to participate in things."