Health insurance for weight loss surgery

Average customer rating: 4.3/5
Written by Joshua Malin
Reviewed by Steven Spicer
Updated 06 June 2024

What is weight loss surgery?

The term ‘weight loss surgery’ can refer to a range of surgical procedures that assist in reducing a person’s weight, and can also be known as bariatric surgery. These procedures are typically done by altering the digestive system to limit the amount of food you can eat.

For a doctor to suggest a weight loss surgery, you typically need a body mass index (BMI) of over 40, or over 35 if you have a serious health problem related to your weight. Type 2 diabetes, high blood pressure and poor heart health are all potential reasons to get a weight loss surgery.1

The right type of surgery for you is between you and your doctor. However, a few of the options include:

  • Gastric bypass surgery
  • Gastric band surgery (lap band)
  • Gastric sleeve surgery (sleeve gastrectomy).

Private health insurance for weight loss surgery

Does health insurance pay for weight loss surgery?

Is weight loss surgery covered by Medicare?

Waiting periods

Cost of weight loss surgery

The cost of your weight loss procedure will depend on several factors such as where you live, the hospital you’re treated in and the doctors who treat you. The table below demonstrates how Medicare and private health insurance contribute to your doctors’ fees, and the typical hospital fees, which can be partially or completely covered by private insurance when you are admitted to hospital as an inpatient.

Procedure (MBS item number) Typical specialists’ fees Average Medicare rebate for specialists Average insurance benefit for specialists Average hospital fees
Gastric banding (31569) $4,100 $1,300 $1,100 $8,600
Gastric bypass (31572) $4,500 $1,500 $1,200 $9,400
Gastric sleeve (31575) $3,600 $1,300 $1,000 $9,800

Source: Medical cost finder. Accessed May 20242

As you can see, if you’re uninsured and choose to self-fund a private treatment, your out-of-pocket expenses could be upwards of $10,000. Keep in mind that this is only the cost of your surgery, and you may also need to pay for your initial consultation and any required follow-up appointments.

Meet our health insurance expert, Steven Spicer

Steven Spicer
Executive General Manager – Health, Life & Energy

As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.

1 Healthdirect – Guide to bariatric surgery. Last updated February 2024.

2 Medical cost finder. Accessed May 2024.