What Insurance Will Cover Weight Loss Surgery

How to get your health insurer to pay for your weight


...han $117 billion in medical costs and lost productivity. This includes $3.9 billion in lost productivity due to obesity among Americans age 17 to 64. People who are obese spend $395 more on medical care per year than non-obese people. Obese individuals see an increase of 36 percent on health care services and 77 percent on medications than those in a normal weight range. ...


Aetna Insurance for Bariatric Surgery Requirments


...essional or exercise therapist. Program must have been done face to face, not remotely. A supervised nutritionist diet programs that is reduced in calories. For people who have a history of psychiatric disturbances – borderline personality disorder, schizophrenia, severe depression, etc. – or are presently under the care of a psychiatrist/psychologist or are using psychotropic drugs, there must be a bef...


Medicare for Weight Loss Surgery - Weight Loss Arkansas


...provide a patient with the ability to pre-authorize their surgical procedure. This makes it all the more important for the patient, with the help of their primary physician and bariatric surgeon , to submit a complete and accurate claim application for coverage. The first step in this process is to speak to our office and attend a free seminar to make sure you understand the scope of Medicare’s requirements and whether or not you qualif...


Insurance - WeightLoss - LifeBridge Health


...nd this information. Even if their insurance plan covers weight loss surgery, they will still need to pay a substantial out-of-pocket sum. Make sure the patients know their specific plan and their current deductible. One more important piece of information: Currently Medicare does not cover weight loss surgery (this includes laparoscopic gastric bypass surgery, laparoscopic sleeve gastrectomy surgery, and l...


Will Insurance Cover My Weight - loss Surgery? - Baptist Health


...or obesity surgery, but you are denied approval, you may be able to appeal the decision. Please discuss this with your surgeon. The Weight-loss Program at South Miami Hospital is a Bariatric Surgery Center of Excellence. This status makes bariatric surgery more accessible to Medicare patients because Medicare does not cover bariatric surgery at non-Center of ...


Insurance for Minimally Invasive, Weight Loss and Cosmetic


...r provider. Here are some items they may require: Proof of multiple failed diet and exercise programs A daily food, diet and exercise log Evidence of obesity related diseases A detailed list of medication currently being taken A letter of medical necessity from your primary physician and our office Don’t give up if your pre-authorization is denied. Make sure that you rece...


Does Medicare Cover Weight Loss Surgery


...rriers, so there is no additional cost to you, our consumer. Learn More To learn about Medicare plans you may be eligible for, you can: Contact the Medicare plan directly. Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week. Contact a licensed insurance agency such as _link_. Our licensed sales agents are available at: Call _link_’s licensed sales agents: 1-8...


Weight Loss Surgery Insurance Coverage - SSM Weight


...nsurance/payment verification process may take up to six months. Billing Process After you have received treatment at the SSM Health Weight Management Services, we will bill your insurance provider. Your insurance provider will notify us after processing your claim and you might receive an “Explanation of Benefits” (EOB) from them which explains how your bill was processed and any fees not covered by your insurance....


Weight Loss Surgery Insurance


...We recommend all patients call their employer’s HR department or the information lines on the back of their insurance card. Oregon Weight Loss Surgery will run an initial benefit check once the application has been received. Please call (503) 227-5050 or toll free 1-800-617-5004 to speak to our insurance coordinator or email: This email address is being protected...


Weight Loss Surgery and Insurance - Tri - State Bariatrics


...ket expenses. Read and understand the “certificate of coverage” that your insurance company is required by law to give you. If you do not have one, consult your company’s benefits administrator or ask your insurance company. Your Primary Care Physician may need to provide you with a referral based on your type of insurance policy. Even if you are not required to get a referral, it is a good idea to ta...


Does Insurance Cover It? - Bon Secours Surgical Weight Loss


...y other methods. 4. Why does it take so long to get insurance approval? Once you have all of the necessary documentation and you submit it to your insurance company is can take 3-4 weeks to longer (if you are not persistent in your follow-up) to get an answer. The Bon Secours Surgical Weight Loss Center has insurance analysts who will assist you with your documentation submission and will follow up regularly on approval requests. It ma...


Obamacare Insurance Won’t Cover Weight - Loss Surgery In


...insurance, they’re not going to get the therapy,” Morton says. “We see cancer therapy covered routinely. We see heart disease covered routinely. Why is it that we don’t see obesity coverage routinely?” Therese Hanna, Executive Director of the Center for Mississippi Health Policy , isn’t surprised that obesity treatments are excluded in plans sold on the insurance exchange in her state. She says it all has to do w...


Weight loss surgery - Doctors, clinics and


... include but are not limited to: The laparoscopic loop or "Mini-Gastric Bypass" is considered investigational Balloon procedures are considered investigational Implantable gastric stimulator is considered investigational (64590) Endoluminal procedures, including but not limited to: Stomaphyx ROSE procedure – restorative obesity surgery - endoluminal Transoral gastroplasty Associated surger...


Health Insurance Will Cover Obesity


...th care plan that does cover obesity treatment­—including bariatric surgery, weight loss programs and nutritional counseling—under the Affordable Care Act, commonly known as “ObamaCare.” (See our table below for state-by-state details.) While not every state has agreed to incorporate obesity treatment into their marketplace health plans yet, this is a significant step in the right direction and we encourage you to revie...


Find out how Insurance Covers Weight Loss Surgery at


...ion and now even with hundreds of patients in the pipeline. He offers this unique one-on-one level of access and you are highly encouraged to stay in touch with him at any point your case is not being addressed to your satisfaction. The Insurance process for your weight loss surgery can be a very stressful process. Our center designates a Patient Advocate to each of our patients. This person wi...


What health insurance companies cover


... 2 pills a day. I went from a size 26-28 to a 16-18. _link_/member/rjpoole/ Most people struggle with paying for the surgery. Go to this site, it is a great support system for you, because it’s only people who have had gastric bypass or lap band. Every insurance program has been rated, and you’ll get tips on how to deal with your insurance company, as well as, surgery tips, food tips, and just support. This site is free! I’d...


Will my insurance cover the cost of Gastric Sleeve Surgery


...eve costs, call us now at (800) 561-9000 to have one of our insurance plan experts perform a verification of your benefits. A standard term used in insurance policies is that coverage is provided for what is "usual and customary" for a Gastric Sleeve procedure. The fees often covered include those associated with anesthesia, the hospital facility use bill, and the f...


Insurance Information - BMI of Texas Weight Loss Center


.... Our comprehensive program will give you the tools you need to lose the weight you want and to keep it off. Because every patient is unique, we strive to design a customized program to meet the needs of each individual. Having the expertise of an Obesity Medicine Specialist, Dr. Jenny Seger, we have the unique opportunity to provide more complete weight management and wellness services tha...


Is Weight Loss Surgery Covered by Insurance


...Company Before your consultation, you should contact your insurance company to make sure your plan covers weight loss surgery.  Here are some tips: Call the customer service number on your insurance card. Tell the customer service representative you are interested in Gastric Bypass/LAP-BAND® surgery and ask if the service is covered on your plan. You may have to phrase this differently such as - morbid obesity s...


Weight Loss Surgery Insurance Coverage - Bariatric Surgery


...te in a six-month medically supervised weight loss program through their bariatric surgeon or their primary care physician before they will cover the cost of the weight loss surgery. Find out your specific requirements regarding diet history by contacting your local Medicare provider. As it stands, weight loss surgery is an option for Medicare beneficiaries with a body mass index (BMI) of 35, with at least one health problem related to...


Insurance for Weight Loss Surgery - Insurance Requirements


... surgery. And some that do provide coverage impose requirements patients must meet before being approved for surgery (e.g., diet history requirement). Your coverage and the requirements you must meet depend on what your employer (or you) purchased in the policy. For example, if you and your neighbor both have Humana insurance, one of you may have coverage for Lap-Band surgery and one of you may not. Our Process Southwest Bariatric Su...


Bariatric Weight Loss Surgery Costs, Insurance


...mit the required information to your insurance provider to gain pre-approval. What are some of the most common bariatric insurance coverage requirements? Some of the most common bariatric insurance coverage requirements include: Body mass index (BMI) greater than 40 or BMI greater than 35 with co-morbidities (diabetes, high blood pressure, etc.). To see if you meet these requirements, you can calculate your BMI using our ...


Blue cross blue shield does the insurance cover weight


... surgery, not all have similar requirements to those of Blue Cross Blue Shield of Michigan.Sep 4, 2008 . An Independent Licensee of the Blue Cross and Blue Shield Association. . weight according to the 1983 Metropolitan Life Insurance Tables (use the. .. Significant weight loss following surgery for morbid obesity can lead to . What insurance plans cover bariatric surgery? ...


Insurance Coverage for Weight Loss Surgery


...licy. Whether you have coverage or a policy exclusion depends not on your insurance company but your employer’s group policy guidelines. If there is a policy exclusion for bariatric surgery your insurance company will NOT cover bariatric surgery under ANY circumstances even if it is medically necessary. Self-pay and financing your procedure are the only choices at that ...


Weight Loss Surgery - Requirements for Insurance Coverage


...e not able to convince the insurance company to pay for weight loss surgery, you may want to consult with Lindstrom Obesity Advocacy _link_), formerly known as Obesity Law & Advocacy Center, for help and advice. Appealing Insurance Denials Citing Lack of Medical Necessity Insurance requests for bariatric surgery are often denied because the insurance company cites a lack ...


Obesity Action Coalition I need a revision to


...ions before they’re asked. I know what you’re thinking. Suppose my insurance company does not or no longer covers bariatric or weight-loss surgery. Well, in that situation you’re going to argue two things. First, that weight-loss surgery should be a covered expense because it is used to treat co-morbidities in addition to obesity, such as diabetes or hyperte...


Do insurance companies cover surgery for obesity


... insurance. If, however, a hernia should have occurred after surgery and this requires additional surgery, removal of this skin can be done simultaneously and may be partially covered. Helpful? 1 person found this helpful. A Dr. Anthony M. Gonzalez, MD , Surgery, answered on behalf of Baptist Health South Florida If you are considering weight-loss surgery, check with...


Obtaining Insurance Coverage for Weight Loss Surgery


...ogether with your surgeon and other experts. Here are some of the key steps you should take to obtain insurance coverage for weight loss surgery: Read and understand the "certificate of coverage" that your insurance company is required by law to give you. If you do not have one, consult your company's benefits administrator or ask your insurance company directly. You will be required to start with your primary care physici...


Health Reform and Weight Loss Surgery/Programs


...free counseling to help you lose weight . You'll get between 12 to 26 sessions. The type of counseling differs depending on the plan. Some people might get one-on-one counseling in person or on the phone. Others might get counseling in a group or through existing programs, such as Weight Watchers . Check your plan's summary of benefits to see the details on what's offered. Can I get the free screeni...


Insurance company's that cover weight loss surgery


...se All insurance companies have policies that will cover weight loss surgery. Are you looking to purchase a policy for yourself, or are you eligible for group coverage through your employer? For individual policies you purchase yourself...you're unlikely to find coverage for weight loss surgery anywhere. If your weight and health issues are that bad, you'll have a hard time getting approved through medical underwriting to even purchase...


What to do When You're Denied Weight - loss Surgery


...t wasn’t meant to be” or “God must not have wanted me to have surgery.” Please do not give the insurer that power because they will surely take it. I also encourage you to consider hiring a professional, such as an obesity lawyer, to intervene on your behalf. If your employer is self-insured but they do not have a bariatric surgery benefit, please visit the OAC Web site. There, you can find a fact sheet titled, “ Why it makes sense to...


Obesity : Should I Have Weight - Loss Surgery


...ng a thin sleeve, or tube, that is about the size of a banana. Because part of your stomach has been removed, this surgery can't be reversed. Examples of restrictive and malabsorptive combined include: Roux-en-Y gastric bypass . A small part of the stomach is used to create a new stomach pouch, roughly the size of an egg. The smaller stomach is connected to the middle portion of the sma...


Laparoscopic Bariatric Surgery


...r program does not guarantee approval of your surgery. If specific dates are required, please call our office. Talk to your family doctor about bariatric surgery. If you do not need a referral, you still need to inform your family doctor that you are seeking this procedure. We may need to contact him or her during the approval process. WellStar Comprehensive Bariatric ...


Bariatric Weight Loss Surgery and Insurance - Nicholson Clinic


...panies, provided the patient meets their requirements. In our experience, the qualifying requirements are often: 35 BMI with underlying health conditions or 40+ BMI without diagnosed underlying health conditions The Nicholson Clinic accepts and files most major insurance plans. As with other healthcare procedures, patients are responsible for deductibles and co-pays. These out...


Insurance and Payment - NJ Bariatrics – Weight Loss Surgery


... of the operation and hospitalization. What’s Next? The next step is extremely important and often overlooked by bariatric patients. You’ll learn what you should you look for when choosing your bariatric surgeon. Choosing Your Bariatric Surgeon » Success Stories I had tried numerous weight loss plans, including Think Thin, Weight Watchers, LA Weight Loss, Diet Center, Nutri System, Jenny Craig, 6-Week Mak...


Insurance Coverage for Surgical Weight Loss at Mercy


...edical necessity – from your Primary care physician Your BMI ( body mass index ) must be 35 or more and you must have at least one of the following; Hypertension High cholesterol Or your BMI is 40 or more, without any of the conditions above. A psychological evaluation to make sure the patient has a clear understanding of weight loss surgery and the impact it will have on one’...


Affordable Care Act : Weight Loss Coverage


...ling sessions can help you change any unhealthy eating and exercise habits. That, in turn, can help you lose weight and lower the chance of health problems. Under the Affordable Care Act , there is no exact definition of what obesity counseling must include. Coverage varies from plan to plan, so call your insurer to see what your policy will cover. If you get insurance through your job, you can also call you...