Weight Loss Surgery Insurance and Financing
The first step you must take after deciding to move forward with your weight loss (bariatric) surgery journey is to contact your insurance company. Many insurance companies require that patients be able to demonstrate that he or she has attempted less invasive methods to lose weight. Every insurance provider has its own guidelines regarding weight loss history and these guidelines are constantly changing. Call your insurance company today and ask them to send you their written policy on weight loss (bariatric) surgery. Your specific policy will assist you in answering a number of important questions, which will include:
Does your plan cover weight loss (bariatric) surgery for Morbid Obesity?
What types of weight loss (bariatric) surgery does your plan cover?
- Roux-en-Y Gastric Bypass
- Laparoscopic Gastric Band placement (Lap Band)
- Sleeve Gastrectomy (Gastric Sleeve)
What criteria must be met in order to be approved?
- Weight or BMI requirement
- Documented weight loss history
- Letter of Medical Necessity
- Clearances (psychological, pulmonary, cardiac)
If your health plan requires prior authorization for any consultation or procedure listed, you must have your primary care physician request for authorization.
Once you complete the process requirements we will submit your file to our insurance specialists for review. After your file is reviewed and all necessary requirements have been met we will submit it to your insurance company for final approval. We encourage our patients to make regular contact with their insurance company to find out the status of the request. If at any point during your weight loss journey you need assistance your bariatric coordinator is there to help.
If you have been denied by your insurance company there is still hope that you will be approved. A bariatric coordinator will work with you to help get you through the appeal process. We have a very high success rate in getting our patients approved both initially and through appeals.
There are self-pay / cash packages available to patients whose insurance policy does not cover weight loss (bariatric) surgical procedures. You should speak with a coordinator in your surgeon’s office regarding these options.