The move is set to benefit many patients as prevalence of obesity in the country ranges from 8-38% in rural areas and 15-30% in urban settings. “Barring a few, the surgery was not covered by many insurance firms as it was considered a cosmetic procedure rather than a life-saving treatment,” experts said.

After the IRDAI’s latest guidelines, every insurance company in the country will have to offer the cover to policyholders who have sought the health insurance policy on or after October 1, 2019. The existing policy holders will be able to avail the benefit from October 1, 2020.

“Bariatric surgery is currently the only intervention, which provides significant and long-term weight-loss for the morbidly obese. It also improves their diabetes, hypertension and quality of life. The IRDAI’s move will benefit a lot of insured patients in the country, who were not able to opt for the surgery due to the cost factor,” senior bariatric surgeon Shashank Shah former president of Obesity Surgery Society of India told TOI.

The Obesity Surgery Society of India (OSSI) and various other organisations had been pursuing the IRDAI to include the surgery under health insurance cover for last many years. The surgeons’ body had also presented a lot of research data to the IRDAI implying health benefits of bariatric surgery to patients with obesity associated problems.

Bariatric surgeon Kedar Patil said, “The inclusion of bariatric surgery as a treatment modality for obesity should have been done long back. The Central Government Health Scheme provides bariatric surgery free of cost to patients under its ambit.”

Patil, however, underlined the need for clarification on some points. “There is no clarity whether the inclusion of bariatric surgery under insurance cover will increase the premium or necessitate co-payment from person undergoing the surgery,” he said, seeking clarity on the time period, after which the insurer will be eligible for the surgery after buying the policy.

Bariatric surgeon Utkrant Kurlekar said, “Insurance firms without hesitation cover treatment for heart diseases, paralysis, joint replacement, which many a times are a result of obesity. So, it was a paradox that the manifestation was covered under insurance, but the root cause wasn’t.”

Insurance companies in the developed countries like the US, the EU and Australia have been providing insurance cover for bariatric surgery for more than two decades now. “I only hope that getting health insurance for obesity surgery would be affordable, otherwise it will defeat the purpose,” Kurlekar said.

Source: The Times of India