Thinking about bariatric surgery is a big step. For many people in Ireland, one of the first questions that comes to mind is not just about the procedure itself but also about how it can be paid for. Private health insurance is often part of the conversation, and patients naturally have lots of questions about what is covered, what is not, and how to navigate the process.
Here are some of the most common questions patients ask about insurance and bariatric surgery, answered for you:
1. Is weight loss surgery covered by private health insurance in Ireland?
Yes, many private health insurance plans in Ireland (including VHI, Laya Healthcare, and Irish Life) do cover bariatric surgery. Coverage can depend on the specific procedure, your policy, and your medical history. The most common surgeries that are usually covered include gastric sleeve, gastric bypass, and SADI-S. Each insurer may have their own rules and criteria, so it is important to check directly with your provider, or you can share your details with us, and we can check the cover for you
2. Do I need to meet certain medical criteria?
Yes. Most insurers set specific requirements before they approve bariatric surgery. Typically, you must have a body mass index (BMI) of 40 or above. If your BMI is between 35 and 40, you will also need to have weight-related health conditions such as type 2 diabetes, uncontrolled high blood pressure, or sleep apnoea. These are known as comorbidities, and they highlight how excess weight is impacting your overall health.
3. Which procedures are typically covered?
Gastric sleeve and gastric bypass are the procedures most often covered by private insurance in Ireland. The best way to be sure is to ask your insurer directly or check with us.
4. Will I need a referral?
If your BMI is 40 or higher, you usually do not need a referral from your GP. However, to begin the insurance pre-approval process, you will typically need a letter from a bariatric surgeon as well as an assessment from a psychologist.
5. Are follow-up appointments and aftercare included in insurance cover?
The aftercare programme with Blackrock WeightCare is not fully covered by insurance. However, in most cases, you can claim back part of the cost over time. For details on how this works with your policy, our team can guide you further by phone.
6. How much of the cost will insurance cover?
Most insurance plans cover the full cost of your admission and surgery. This comes as a surprise to many patients, but it is true!
You may still have an excess or some out-of-pocket expenses. It is important to understand the process and costs involved by speaking with us directly.
7. How long does the approval process take?
Approval can take time, especially if additional medical reports are needed. On average, it may take 4 to 6 months from the point of your initial consultation. Having all of your paperwork ready, including GP or endocrinologist referral letters, psychologist reports, and any test results, can help speed things up.
8. What if my insurance does not cover the surgery?
If your insurance does not cover bariatric surgery, you may choose to self-fund. Many patients decide this is a worthwhile investment in their health when they consider the long-term costs of ongoing medications, such as weight loss injections, which often do not provide lasting results in the same way surgery can. Surgery improves health dramatically, reduces longer term healthcare costs and improves your life expectancy – investing in this seems sensible.
Speaking with our team will help you weigh up the options and understand the best path forward for your situation.
9. Will insurance cover revision surgery?
Revision surgery is sometimes needed if the first operation has not delivered the expected results or if complications occur. Most insurers will cover revision surgery if the first procedure was self-funded and not claimed through insurance.
If the first operation was paid for through your insurance, a special application must be made to see if your insurer will fund a further procedure.
10. What should I do first if I am considering surgery?
The first step is to speak with our team and share your insurance details so we can check the cover. From there, we can guide you towards the right bariatric consultation.
Insurance can feel complicated, especially when you are already trying to make a big decision about your health. The important thing to remember is that you do not have to figure it all out on your own. A consultation with our team can help you understand your options, and your insurer can provide clarity on your cover.
At Blackrock WeightCare, we see every day how life-changing bariatric surgery can be. Our team is here to answer your questions, support you through the process, and guide you towards the most effective path for your health.
Your Health. We Care.
