Does SSI or Private Insurance cover the sleeve gastrectomy?
Obesity is a serious health problem in our country as well as all over the world. The increasing frequency of obesity in the society significantly increases health expenditures with the additional health problems caused by obesity. In our country, patients who meet certain criteria can have free surgery within the scope of SSI in state hospitals with obesity centers. Especially, patients who successfully complete a 6-month training period called the obesity academy in order to be able to have surgery in public hospitals can only have the chance to have surgery. Considering that there are nearly 20 million obese people in our country, state hospitals may be insufficient to provide this service.
Also, patients who meet the criteria can have obesity surgeries in private hospitals by paying the treatment difference. It is required to have an intensive care service in the relevant health institution in terms of patient health and to manage the complications that may occur in the same health center in order to perform obesity surgeries in private hospitals.
Private health insurances do not cover obesity surgeries in today’s conditions. Obesity surgeries are more likely to be covered considering the budgets paid by insurance companies for additional obesity-related diseases. It is expected that private insurance companies will reconsider this issue in the future. Gastric balloon application, which is one of the most efficient treatment methods without surgery, is not covered by any state or private health insurance.
What are the SSI criteria for sleeve gastrectomy?
People must have a body mass index of over 40 or a body mass index of over 35 and have additional obesity-related diseases such as diabetes and blood pressure in order for these surgeries to be covered by SSI. Persons who will undergo surgery must be proven to be suitable for surgery by a committee consisting of specialists in internal medicine, endocrinology, psychiatry and general surgery.