Will my Insurance Plan Cover Bariatric Surgery?

Since every insurance policy is unique, it's important that you thoroughly understand your certificate of coverage to know exactly what is and isn't covered through your plan.

To qualify for insurance coverage, many insurers require patients to have a history of medically supervised weight loss efforts. Insurance companies may consider the following efforts when evaluating the appropriateness of bariatric surgery including laparoscopic gastric banding:

You may also get partial coverage for the LAP-BAND System surgery. There may be a way to have some of the tests covered, or perhaps have another (approved) abdominal surgery done simultaneously; thereby covering some of the anesthesia and hospital fees.

Additional:
A Letter of Medical Necessity and weigh-loss history are necessary to obtain prior authorization for obesity surgery. A Letter of Medical Necessity states why significant weight loss is medically necessary for a patient and usually includes the following information:

• Patient's weight
• List of medical problems associated with obesity, such as type 2 diabetes, sleep apnea, hypertension, etc.
• Number of years patient has been overweight (which should be at least five or more)
• Number and types of failed weight-loss programs attempted in the past

Create a document or packet listing all your weight-loss attempts (self-controlled or medically supervised) and their results and you will substantially increase your chances of getting insurance coverage for the LAP-BAND procedure. You should include any commercial diets or medical records of your weight-loss efforts.

Our center accepts most insurance plans. You may submit information regarding your insurance carrier in the Patient/Inquiry department. Our staff will verify your insurance information and determine if your insurance covers the procedure. Insurance will be considered for this surgery if proper documentation is provided to substantiate medical necessity.

You may also contact us at:
Tel.
and provide us your insurance information over the phone for verification.

Considerations

Medical problems commonly resulting from untreated obesity include:

• High Blood Pressure
• Stroke
• Diabetes
• Cancer
• Respiratory Problems
• Depression
• Osteoarthritis
• Coronary Artery Disease
• Hypertension
• Gall Stones
• Obstructive Sleep Apnea
• Poor Female Reproduction
• Psychological Disorders