Low-income patients need to look under the right rocks to pay for weight loss surgery without insurance.
Government grants are perhaps the best resource for financial assistance. But you cannot start at the source. Instead, you have to follow the flow of money and apply at the appropriate downstream pool: with a different name.
Funding organizations illustrate the point. You can count on one hand the number of people that private charities might help, whereas Medicaid pays for thousands of operations annually.
Finally, looking for free gastric bypass is a flawed strategy because charity care addresses acute needs, and clinical trials have strict criteria.
Free Weight Loss Surgery
How do you get free bariatric surgery without insurance? Grant programs are the ideal starting point because government funding is more widespread and available than pro bono services through clinical trials and charity care.
A handful of funding organizations might provide grants for bariatric surgery to patients without insurance. However, government programs with creative labels help more people than charities that rely on donations.
The Weight Loss Surgery Foundation of America (WLSFA) is a charitable organization that relies on donors’ generosity to issue grants to help self-pay patients afford their procedure.
Since its inception in 2010, it has assisted twenty-eight people or only about three per year. Also, WLSFA suspended financial assistance during the COVID pandemic due to impacts on fundraising.
The American Society for Metabolic and Bariatric Surgery (ASMBS) provides scientific research grants to combat obesity. However, the funding goes to doctors rather than uninsured patients.
Medicare provides funding for bariatric surgery to senior citizens and some disabled individuals who meet the medical definition for morbid obesity.
This government-run program could help thousands of people annually who work with their surgeon to submit the appropriate documentation.
Free Clinical Trials
Free clinical trials for weight loss surgery can help just a handful of morbidly obese people each year. Clinical trials recruit patients meeting narrow criteria who might be willing to undergo an experimental treatment.
In exchange for acting as a test subject, the doctors may provide pro bono services that do not require insurance.
The challenge lies in finding a free clinical trial that matches your exact medical condition, previous dieting and exercise regimens, and geographic area. The doctors may run various experiments and test new devices and therapies.
Several online databases point potential clients to possible studies.
Free Charity Care
Charity care for weight loss surgery is an unlikely source of a free gastric bypass or lap band procedure. Uncompensated care (Charity) is a government-funded effort designed to help uninsured patients who cannot afford treatment for acute medical conditions.
Acute medical conditions happen suddenly, last a short time, and require immediate attention. Morbid obesity is the opposite. It is a chronic condition that develops slowly over the years or decades.
Charity care is not a good alternative for free treatment when you have the luxury of time to enroll in Medicaid or private health insurance (see above) to address your chronic problem.
Weight Loss Surgery Grants
Bariatric surgery grants are one way that patients can pay for their procedures without insurance. Grants represent money from a third party that you do not have to repay, making them much better than financing – if you can find them.
The federal government is the primary source of this financial assistance. However, it does not award grants to individuals. Therefore, you need to track how the funding flows and apply for benefits at end-point programs with other labels.
Medicaid often covers bariatric surgery when medically necessary, allowing us to label this end-point as a grant for extremely low-income patients without insurance. In this case, the government money flows to the states that establish eligibility criteria based on the Federal Poverty Level (FPL).
Your eligibility depends on household size and the state where you live.
- Expansion states: up to 138% FPL
- Non-expansion states:
- Parents: 17% to 100%
- Individuals: 0% to 100%
Individual health insurance often covers bariatric surgery when medically necessary. Plus, federal money supports two types of subsidies, allowing us to label this program as government grants for low-income patients.
People who do not qualify for Medicaid may be eligible for two subsidies for households between 100% and 400% of the Federal Poverty Level.
- Premium tax credits that lower the cost of coverage
- Cost-sharing reductions that lower out-of-pocket expenses
To take advantage, you need to buy coverage and then establish medical necessity.
Many morbidly obese individuals with a medically necessary condition have no reason to pay for bariatric surgery without insurance – especially given the government grant money that lowers premium and out-of-pocket costs.
The procedure is elective, which means that you can schedule the operation conveniently for you. You can buy individual insurance via your state marketplace, and the policy must cover any pre-existing conditions immediately.
However, your state laws dictate whether this strategy works. Most mandate coverage for bariatric procedures, while others require companies to offer at least one plan, and nine have no stipulation.
|Mandate to Offer||Not Required|
|Indiana||District of Columbia|
Morbidly obese individuals with a medically necessary condition living in one of the forty-one mandate states have no reason to pay for bariatric surgery without insurance! Now that you have coverage in force, the next step is building a case so you can take advantage of your government grant: premium and cost-reduction subsidies.
You, in combination with your surgeon, need to establish medical necessity.
- Prior participation in clinical weight loss program
- Body Mass Index (BMI) above 40
- BMI above 35 with obesity-related health problems
- High blood pressure
- Sleep apnea
- Elevated cholesterol
Middle Income Grants
The IRS allows patients to deduct unreimbursed medical expenses, which permits us to label this tax law as another type of grant for weight loss surgery without insurance. However, this opportunity benefits a narrowly defined group.
- People whose itemized deductions exceed the standard deduction
- Single: $12,550
- Joint: $25,100
- Head of Household: $18,800
- Patients whose unreimbursed medical expenses exceed 10% of Adjusted Gross Income (AGI): only the amount above this level generate savings
Middle-income patients benefit most because they pay a higher marginal rate while still deducting expenses above 10% of AGI. For illustration purposes, compare the savings of two single filers with no other unreimbursed medical expenses.
- AGI of $100,000 in the 22% bracket
- AGI of $200,000 in the 32% bracket