Bariatric Surgery and Insurance

If you are considering a bariatric procedure, most likely you are also wondering if it will be covered by your insurance. The good news is that nowadays many health plans do cover at least part of the cost for weight loss surgery. Most insurance companies find that a weight loss surgery is a good investment. The Obesity Action Coalition reports that the costs of the procedure are usually paid off within about 3.5 years, because patients normally experience a dramatic improvement in their overall health, thus reducing hospitalization and medication expenses. To find out if your insurance covers weight loss surgery and what requirements you need to meet, call your insurance provider to ask if they cover bariatric surgery specifically, as coverage between carriers can vary.

Weight loss surgery for Medicare patients

Medicare beneficiaries do not need any pre-authorization, as long as they meet certain criteria. However, you will probably be required to participate in a physician-supervised weight loss program beforehand. It is important to know that Medicare covers three types of bariatric procedures:

  • The Roux-en-Y bypass
  • Open and laparoscopic biliopancreatic diversions
  • Laparoscopic adjustable gastric banding

Other insurance providers

Other insurance companies typically require a proof that a bariatric procedure is necessary for you. For that, it is best to gather as much supporting documentation as possible, including a letter from your primary physician confirming your need for weight loss surgery. Generally, you will be expected to provide the following information:

  • Your physical parameters (weight, height and BMI)
  • Your “weight history” (how your weight has changed throughout your life)
  • Information about any obesity-related (co-morbid) health conditions and treatments, including high cholesterol, high blood pressure, diabetes, vascular diseases, arthritis, sleep apnea, GI problems etc.
  • A list of medications you currently take
  • An explanation of how your excess weight affects your daily life
  • A complete history of all your dieting efforts, including a documented physician-supervised diet plan, any visits to healthcare specialists for weight-related problems, other weight loss programs, gym memberships etc.

Normally, a well-substantiated request will be approved. However, in case it is denied, you will still have a chance for it to be approved if you immediately file an appeal. Alternatively, you can pay for the procedure out of pocket or apply for a loan to cover costs of the procedure.

It is also good to know that after paying cash or financing your surgery, you may be eligible to receive thousands of dollars in form of tax savings. Your tax advisor will be able to determine if you qualify for this kind of tax break.

The process of financing a surgery may sometimes be complicated, but there is no reason to feel discouraged. Our experienced staff is here to assist you! Here at Delaware Weight Loss Surgery Center we have helped hundreds of patients achieve their weight loss goals and we know that bringing such dramatic changes to your life can be challenging. That is why we have developed a comprehensive care and support system to help you on every step of your journey to a healthier life.

If you would like to learn more about our services, schedule an appointment or sign up for ourfree seminar, please visit our website at http://www.chrias.com. You can also call 302-890-9900 or email us at info@chrias.com. Our team of experienced specialists is looking forward to making your weight loss efforts a long standing success.

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