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Navigating the realm of health insurance coverage for weight loss surgery can be complex, yet it’s a crucial aspect of embarking on your transformative journey. At Precision UpperGI Surgery, led by Dr. Manju, situated in the heart of Sydney, NSW, we recognise the importance of understanding your options. In this comprehensive guide, we’ll provide you with valuable insights into the nuances of health insurance coverage for weight loss surgery, ensuring that you’re well-informed and empowered to make the best decisions for your well-being.

Decoding Health Insurance: Unveiling Coverage Options

When considering weight loss surgery, it’s essential to explore your health insurance coverage options. Different policies and plans may provide varying degrees of coverage, and deciphering the details can be overwhelming. Our expert team is here to simplify this process for you. We’ll carefully review your insurance policy and provide a clear breakdown of what procedures may be covered, ensuring that you’re equipped with the knowledge you need to make informed choices.

Eligibility Criteria: Meeting Requirements for Coverage

Eligibility criteria for health insurance coverage can vary based on factors such as your medical history, body mass index (BMI), and associated health conditions. Our experienced professionals at Precision UpperGI Surgery will assess your individual situation and guide you through the process of meeting these criteria. By understanding the requirements, you can work towards fulfilling them and positioning yourself for potential coverage of weight loss surgery procedures.

Bariatrics Cost Enquiries

Your costs will depend on

  • The type of surgery – Sleeve gastrectomy, bypass, revision surgery
  • Insurance status – Insured or uninsured
  • The cost includes 24 months of follow-up with the surgeon
  • Specialist’s costs (dietician, psychologist and endocrinologist if needed) are not included

Pre-Approval Process: Navigating Documentation and Forms

The pre-approval process is a crucial step in securing health insurance coverage for weight loss surgery. It involves submitting the necessary documentation, medical records, and forms to your insurance provider. Our team is well-versed in the requirements of various insurance companies and can assist you in compiling and submitting the required information accurately and efficiently. This proactive approach maximises your chances of receiving timely approval for your procedure.

Coverage Limitations: Unveiling the Fine Print

While health insurance coverage can provide substantial financial relief, it’s important to be aware of any limitations or exclusions that may apply. Our team at Precision UpperGI Surgery will meticulously review your insurance policy to identify any potential restrictions on coverage. This transparency empowers you to make decisions with a full understanding of what costs you may be responsible for and what benefits you can expect.

Expert Guidance: Navigating the Claims Process

After your weight loss surgery, the claims process is the final step in utilising your health insurance coverage. Our experts are here to guide you through this process, ensuring that you submit the necessary documents and information accurately. We understand that the claims process can be daunting, especially during your recovery period. Rest assured that we’re here to support you every step of the way, making the process as seamless as possible.

If the patient is Insured:

the costs covered by your health insurance will depend on the procedure and because obesity is a chronic condition you will have to wait 12 months from joining a health fund to getting the surgery. To find out if and how much you are covered, we suggest you contact your health fund with the following item numbers: Gastric bypass (Item No 31572), Gastric Sleeve (Item No 31575).

Dr Manju’s out-of-pocket costs will vary depending on the type of surgery and how much your health insurance would cover the cost. It is generally between 5K-6K for primary surgery. Revision surgery would be more.

If the patient is uninsured:

The cost of surgery is 5K-6K for primary surgery. The anaesthetist, assistant and hospital costs are separate, and this will depend on the hospital you end up choosing.

Can I use my Super?

You might be able to apply for compassionate early release of super to cover some or all of costs. This can be done via an online form or with a paper form and then contacting your Super. More information and access to forms is available on the ATO website or also by calling the ATO directly

Is there a Medicare rebate?

Yes, there is, we can discuss these with you after the first appointments

Making Informed Choices: Your Partner in Health

At Precision UpperGI Surgery, led by Dr. Manju, we’re not just a medical practice – we’re your partners in health. We believe that informed decisions lead to positive outcomes, and that’s why we’re committed to providing you with the knowledge and support you need to navigate health insurance coverage for weight loss surgery. Your well-being is our priority, and we’re dedicated to ensuring that you have the resources and assistance necessary to make the best choices for your journey.


Understanding health insurance coverage for weight loss surgery is a pivotal aspect of your transformation. At Precision UpperGI Surgery, led by Dr. Manju, located conveniently in Sydney, NSW, we’re here to guide you through every step of this process. From deciphering coverage options and eligibility criteria to navigating the pre-approval process and claims submissions, our expert team is by your side. Contact us today to embark on your journey towards transformative health and well-being, equipped with the knowledge to make the best choices for your future.