Bariatric Surgery: FSA Eligibility

Bariatric Surgery: eligible with a Flexible Savings Account (FSA)
Bariatric surgery is eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA), and health reimbursement accounts (HRA). They are not eligible for reimbursement with dependent care flexible spending accounts and limited-purpose flexible spending accounts (LPFSA).

What is Bariatric Surgery?

Bariatric surgery, also known as weight loss surgery, includes a variety of procedures performed on adults who have severe obesity. It is an option for weight loss for those where obesity poses severe health complications. Clinically severe obesity is defined as those who have a Body Mass Index (BMI) greater than 35. Some of the health problems that adults with obesity could experience include Type 2 diabetes, heart disease, severe sleep apnea, and others.

Weight loss through bariatric surgery can be achieved through a couple of methods. Doctors can reduce the size of the stomach with a gastric band, remove a portion of the stomach, or resect and re-route the small intestine to a small stomach pouch in a gastric bypass surgery (MedlinePlus).

What are the benefits and/or consequences of Bariatric Surgery?

Results of bariatric surgery vary and there is no sure method to produce and maintain weight loss. Studies have shown that the procedures can cause significant long-term loss of weight, improvement in cardiovascular risk factors, and a reduction in mortality. However, some patients who have bariatric surgery may only have a marginal weight loss or even regain some of the lost weight over time. In the long term, success may be more contingent on curtailing habits and constant medical follow-ups (American Society for Metabolic and Bariatric Surgery).

When should one consider getting Bariatric Surgery?

Recent National Institutes of Health (NIH) guidelines suggest that any patient with a BMI of more than 30 is a candidate for bariatric surgery, and it is recommended if BMI is at least 40 or if patient has serious health conditions. Not all patients are suitable for Bariatric Surgery so it is best to consult a doctor on whether bariatric surgery is the right option.

Bariatric surgery is also sometimes used to treat youth with extreme obesity. Experts in childhood obesity suggest that families consider surgery only after they have tried for at least 6 months to lose weight and have been met with little to no success.

How much do bariatric procedures cost?

On average, costs range from $20,000 to $25,000. Bariatric surgery may be covered only under certain conditions:

  • If the patient has at least one health problem linked to obesity
  • If the procedure is suitable for the patient's medical condition
  • If approved surgeons and facilities are involved