How To Get Your Insurance To Pay For Weight Loss Surgery


Weight Loss Surgery Payment Options - BMI of Texas


Redefining healthcare by creating meaningful relationships and experiences with our patients and the community in order to overcome obesity and metabolic disease fostering improved health and a better quality of life. If you are like most people, you are probably extremely frustrated and tired of dealing with excess weight. Our comprehensive program will give you the tools you need to lose the weight you want and to keep it off. When it comes to Texas obesity surgery, it is our goal to not only help you achieve your weight loss goals but to improve your overall health and quality of life.


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Is Weight Loss Surgery Covered by Insurance


Qualifying for Bariatric Surgery with Your Insurance Company. Before your consultation, you should contact your insurance company to make sure your plan covers weight loss surgery. Tell the customer service representative you are interested in Gastric Bypass/LAP-BAND® surgery and ask if the service is covered on your plan. If they say the service is not covered or is excluded, this means your employer or whoever you get your insurance through, did not pay for this benefit. Do I have to have certain co-morbid conditions (medical conditions related to your weight?)  If so, what are the conditions? Do I have to complete a physician supervised diet, and for how long? Can you provide me with a checklist (the requirements for surgery)? Please contact our insurance department if you have any questions: 515-241-2250. We strongly encourage patients to contact their insurance companies to see what is required for their pre-approval. If this is a requirement of your insurance plan we can not submit your pre-approval until this diet is completed. Contact your physician and ask if this diet was documented in your medical records. Don't forget to contact your insurance company because their requirements may be different than what you have already completed. Again, check with your insurance company to see what they require for insurance approval.


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Find out how Insurance Covers Weight Loss Surgery at


Insurance coverage and the cost of weight loss surgery are perhaps one of the greatest concerns for patients who consider surgical weight loss. Patel he will review whether or not you have the benefit of weight loss surgery, what your benefit plan requires you to do to prove medical necessity, and what your out-of-pocket expense will be if you pursue surgery. Dealing with an exclusion in your insurance regarding weight loss surgery; Additionally things in the insurance environment and with your employer’s policies change constantly and Dr. One should never consider it a waste of time to visit with the surgeon and to be initiated into a program for your overall well-being even if the insurance company says no. You will then be assigned a unique username and password which will allow you to access our database online from any computer in the world in order to evaluate where you are in your insurance authorization process. This is unique to any program in South Texas, where you can have a moment-by-moment update in regards to your progress through a tedious insurance verification process and authorization process. The assignment of advocate is based upon your insurance and the timeline which you are going to be able to achieve surgery and where you are going to pursue your physician supervised program. Patel regarding your weight loss surgery insurance benefit and your out-of-pocket expenses, and a timeline within which your surgery should be able to be approved are not being met by your standards, you are encouraged to email Dr. The Insurance process for your weight loss surgery can be a very stressful process. Call your insurance company for you and verify if your company offers the benefit. Walks you ‘step-by-step through all the things that the insurance company will require to do if coverage is available. Will my insurance pay for my surgery? Many insurers will cover your weight loss surgery, however it is difficult to achieve insurance authorization on your own. Does Insurance Cover Weight Loss Surgery?


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How to get Insurance Approval for Bariatric Surgery


Severe obesity is one of the leading causes of preventable deaths in US, according to the Centre for Disease Control and Prevention. Bariatric surgery comes as a lifesaver treatment for such people who have had successive failures with conventional obesity treatments and strategies like medication and exercise. Weight-loss through bariatric surgery is achieved mainly by restricting the capacity of stomach to hold food. This limits the amount of food in stomach and makes one feel full. Malabsorptive surgery: Most of the digestion and absorption in body takes place through small intestine. Getting approved by insurance companies for bariatric surgery:  According to the American Society for Metabolic and Bariatric Surgery, there are many evidences to prove that bariatric surgery can help cut down more than thirty weight-related health problems. Looking into the cost of the surgery, the majority of patients want to get approved for insurance to cover their weight-loss surgery. They have several assumptions about the policies and procedures related to getting approval from insurance companies. If you have health insurance and you want to undergo weight-loss surgery, it is important to read the policies and discuss with your insurer and surgeon to ensure that you get approval for your weight-loss surgery. Most of the insurance companies ask for documents to prove that your surgery is essential. Discuss with your surgeon to check your medical history and provide all the documents for your obesity-related health issues. In addition to this, some of the insurers require complete psychological evaluation of the patient to rule out unhealthy lifestyle and some psychological health problems. The letter will have your complete medical history and other obesity related health problems. Learn more within the Bariatric Surgery Resource Guide .


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Insurance coverage for lap - band surgery


Insurance coverage for the Lap Band procedure. Insurance coverage for the Lap Band surgical procedure is determined on a person-by-person basis. You may also see if you can get partial coverage for the LAP BAND System surgery. The first step is to check your "certificate of coverage" for benefits or exclusions of lap band surgery. Check the Patient Criteria and Medical Requirements for Lap Band Surgery. If lap band surgery costs are covered by your insurance plan, the next step is to find out the patient criteria and medical requirements for the procedure. Since weight loss surgery is considered the last method of treatment for obesity, you will need to provide documentation to the insurance company of previous weight loss attempts. In order to verify that you meet the patient criteria for lap band surgery, your primary care doctor and/or bariatric surgeon will need to send a Letter of Medical Necessity to the insurance company. Many lap band patients have been successful in the appeals process, but you should be prepared to be diligent in meeting the insurance company's requirements and pressing for lap band surgery coverage. If your insurance plan has an exclusion for weight loss surgery, it may still be possible to get approval if you obesity co-morbidities.


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Paying for your Surgery - The Davis Clinic


A:  In order to confirm whether you have coverage for bariatric surgery or not, you may call the customer service number on the back of your insurance card.  A: If your insurance provider indicates that you have coverage “if it is deemed medically necessary,” this means that you have benefits for weight loss surgery. The insurance experts at our office will verify the specific benefits you have and will go over all of the specifics about your insurance coverage and the requirements for approval for surgery when you meet with us at your first consultation with your surgeon . If your insurance provider indicates that you have an “exclusion” on your policy, this means that your employer has opted not to cover this benefit for employees. If you have an exclusion, we recommend that you to speak with your human resources director and ask if there may be plans to cover this benefit in the coming year. Q:  How much does the surgery cost if my insurance will not pay for it? Upon registering on our Patient Portal , we will verify your benefits and will be happy to speak with you about the options available if you do not have coverage for weight loss surgery. Following your consultation with the surgeon, a financial advisor will meet with you to discuss your financial responsibility for the surgery you and the surgeon agree will be best suited for you. A:  In the year you finance or pay cash for your bariatric (weight loss) surgery, you may be eligible to receive money back in potential tax savings. Although the processes of calculating tax deductions are by no means precise and can be quite complex, you may be able to deduct a portion of your medical expenses, including the costs associated with your weight loss surgery. The rules for tax deductions for medical expenses are established by the Internal Revenue Service and explained in Publication 502.


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


Of one thing you can be sure, you are not the first person to be denied approval for weight-loss surgery by your insurance; nor will you be the last. While access to care has most certainly improved for many in the last few years, coverage for weight-loss surgery is not standardized and can vary tremendously based on your employer and your insurance plan. The good news here is if your employer is self-insured with a bariatric surgery benefit and you have documentation, you meet all of the criteria on the plan and you are denied, they do not have a leg to stand on! This is where your surgeon will speak with the medical director at the insurance company to review your documentation and to point out how you meet the criteria. If your employer is self-insured but they do not have a bariatric surgery benefit, please visit the OAC Web site. While you are advocating for future coverage, it may not be enough to help you in your immediate goal to have surgery. Then approach your employer with the information from your bariatric program, the resources listed at the end of this article, and the total costs to self-pay for surgery (that includes covering any potential complications and ask them to pay the surgeon and program directly or ask them to share the cost with you). Work with your surgeon/program to complete a peer-to-peer review if your company covers surgery and you meet the criteria. “Thank you for your interest in bariatric surgery, unfortunately your plan does not cover this procedure.” As you can see, hearing that you’ve been denied weight-loss surgery does not have to be the “final word.” As an informed citizen, you have many options to first educate yourself on the procedure and then advocate to your insurance provider, employer, elected officials and others for coverage.


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Insurance and Payment for Your Weight - Loss Surgery


  > insurance and payment for your weight loss surgery. Insurance and Payment for Your Weight-Loss Surgery. Insurance Considerations for Patients Considering Weight Loss Surgery. Most patients have health insurance benefits, which allow coverage for bariatric surgery. The following is a list of insurance companies and their current policies on weight loss surgery. For patients who do not have insurance that will authorize weight loss surgery we do have a self pay option. However, most insurance companies do authorize weight loss surgery and we have a very high success rate at authorizations. We are able to get most insurance companies to authorize and pay for most of the hospital charges and some of the surgeon fees. Our preference is for you to use your insurance to avoid the significant hospital and other related costs. Please be aware that most insurance companies do authorize the Gastric Bypass , fewer authorize the Duodenal Switch , and Lap Band ®, and the Vertical Gastrectomy . In most states, review boards can - and often do - overturn an insurance company's denial for surgery.


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Bariatric Surgery Insurance Appeals


Simply put, do you actually have the same insurance coverage you think you have, or that you know you previously had? But you do have a right to know who your payer is and find out what is (and is not) covered under that plan. Once you get it, review the coverage and exclusions carefully to determine whether you have insurance for your weight loss surgery. You complete the 6 months and after the surgeon submits the request only to be informed that your insurance changed and does not cover your surgery. Shouldn’t they be forced to cover it since I had coverage when I started this?!?” The answer offered by the insurance company is “No, the coverage in place at the time of your operation is what controls.” Simply starting the diet, even if “they told you to,” does not necessarily create a right for you to get surgery if the coverage changes mid-stream. But the real lesson to be learned is to not “Take for Granted” that you have coverage today and assume you will have coverage tomorrow. You’re not even sure you want to have surgery and even if you do, which surgery is right for you? “Where should I have this done?” “What program is best for me?” There is much homework to do and doing that homework right is the most important phase of your journey — you want to be sure you are doing the right thing for you! Those who have had surgery (like Walter) will tell you it is not the easy way out so it is best to be sure of your choice and take the time you need in order to be comfortable with your decision. We can debate another time if they have good reason to require this [they DON’T!] but for now, the questions to consider are “what kind of diet?” and “what kind of documentation?” These tips will help you no matter who your insurance company is or whether your plan is “self-insured” or “fully-insured”.


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Seeking Insurance Approval for Your Weight Loss Surgery


Seeking Insurance Approval for Your Weight Loss Surgery. One of the happier moments in your weight loss surgery journey is when you get the seal of approval from your insurance company. Most insurance companies realize the long-term effects and cost savings associated with the weight loss that occurs after patients have weight loss surgery. For example, if you have diabetes, your insurance company will spend thousands of dollars covering your medications and treatment. Over the past few years, insurance carriers have seen a significant increase in the demand for weight loss surgery procedures. Your height, weight history, and body mass index (BMI) A detailed history of the results of your dieting efforts, including medically- and non-medically-supervised programs. If your primary-care physician cannot be persuaded, you may have to find another primary-care doctor who understands the necessity for your surgery. Be sure to make copies of the letters for your records. Someone in the office should be able speak to you about your insurance concerns and questions.


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Financing Weight Loss Surgery


Getting Your Insurance to Pay for Weight Loss Surgery. In fact, most insurance companies require that the patient's weight be stable during this time - with no up-and-down fluctuations - or you may be denied coverage. They want you to demonstrate over the 6 months prior to surgery that you can commit to lifestyle changes you’ll need to make forever after your weight loss surgery. This is to make sure that you understand weight loss surgery and the impact it will have on your lifestyle. When you have completed these steps, the surgeon will send a preauthorization letter to your insurance company. The letter will outline your medical history and health problems related to your weight, and provide documentation that you have completed all requirements for approval. The insurance company will then review your case. During this period, keep accurate notes of all communications between the insurance company and your surgeon.


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Gastric sleeve insurance - Obesity Weight Loss Surgery


As a result, many insurers now cover all or some of the costs associated with gastric sleeve surgery . Insurance coverage for gastric sleeve surgery varies by state and insurance provider. Gastric Sleeve Insurance Coverage: What Is Covered? Insurance coverage for gastric sleeve surgery tends to be similar in scope to coverage of other bariatric surgeries. Some insurers may pay the entire bill, but others only pay 80 percent of what is considered "usual and customary" for gastric sleeve surgery. If you are considering gastric sleeve surgery, contact your insurance plan to find out if the procedure is covered, and what such coverage entails. Gastric sleeve insurance coverage may include the program elements that are necessary to be successful with your procedure such as support groups, exercise and nutrition counseling. Some people may not lose enough weight with the gastric sleeve surgery alone and may need a secondary procedure such as duodenal switch or gastric bypass surgery . Insurance carriers cover the cost of gastric sleeve surgery if you meet certain pre-specified criteria, which vary by company. United Healthcare will cover the cost of gastric sleeve surgery for individuals with a BMI of 40 or higher, or a BMI 35 to 39.9 and one obesity-related illness. If a person has severe heart and lung problems associated with obesity, however, they may lower the BMI requirement and cover the costs of gastric sleeve surgery. Gastric Sleeve Insurance Coverage: Action Points. Gastric Sleeve Insurance Coverage: Other Options. If you choose to pay cash for gastric sleeve surgery, complications may not be covered. Some bariatric surgery centers may offer "reinsurance" plans that will cover the cost of complications during the first year after surgery if you pay cash for your gastric sleeve surgery.


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Health Insurance Will Cover Obesity


Health Insurance Will Cover Obesity Treatment in 2015. In an exciting new development, many Americans will soon have the option to switch to a health care plan that does cover obesity treatment­—including bariatric surgery, weight loss programs and nutritional counseling—under the Affordable Care Act, commonly known as “Obama Care.” (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 review your options. All enrollment closes on February 15, 2015, after which you will no longer be able to sign up for a health plan in or out of the Health Insurance Marketplace for the rest of 2015. Consult the table below to see which obesity treatments your state includes. If you live in a state that does not offer coverage for weight loss treatment in the Health Insurance Marketplace, there may be private insurance providers in your area that do. Whether or not you can obtain a plan that covers weight loss treatment options, NOF can assist you in finding an accredited bariatric surgeon in your area that best suits your needs. Obesity Treatment Options Under the Affordable Care Act by State.


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Weight Loss Surgery - Requirements for Insurance Coverage


Overview of Insurance Coverage for Weight Loss Surgery. Many insurance companies will provide coverage for weight loss surgery if it is considered a medical necessity and the patient meets the National Institute of Health (NIH) requirements for bariatric surgery. Some states have passed laws that require insurance companies to cover weight loss surgery if the patient meets the NIH health criteria. Even among insurance companies that provide coverage for the weight loss surgery cost , surgery benefits will usually not be considered unless other weight loss methods have been attempted. NIH Requirements for Weight Loss Surgery. Most insurance companies require a Letter of Medical Necessity for bariatric surgery pre-authorization. Many insurance companies will not consider a request for weight loss surgery unless a patient has previously participated in a medically supervised weight loss program. Appealing Insurance Denials for Bariatric Surgery. If you submit a request for pre-authorization of weight loss surgery and receive a denial from your insurance company, it may be discouraging but it can be appealed. If you and your doctor are not able to convince the insurance company to pay for weight loss surgery, you may want to consult with Lindstrom Obesity Advocacy (www.wlsappeals.com), formerly known as Obesity Law & Advocacy Center, for help and advice. Appealing Insurance Plan Exclusions for Weight Loss Surgery.


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How to get your health insurer to pay for your weight


How to get your health insurer to pay for your weight-loss surgery. Even with your doctor’s recommendation and coverage available from your health insurance policy, your health insurer might not pay for the surgery. If you’re considering bariatric surgery and want your health insurance to pay for it, you may have to jump through a few hoops. It's common to find health insurance companies that will not pay for weight-loss surgery, yet these same insurers are paying for years of treating the conditions associated with obesity. Your best chance for attaining insurance coverage for weight-loss surgery is through a group health plan.  The American Society for Metabolic and Bariatric Surgery certifies "Centers of Excellence" around the country. For Aetna plans that do cover bariatric surgery, here is a summary of the criteria for gastric bypass approval: Bariatric surgery is specifically excluded under the standard CIGNA Health Care plan, but employers can elect to include or exclude coverage for bariatric surgery in their group health plans. CIGNA Health Care also covers medically necessary reversal for bariatric surgery when a patient has complications and, under certain circumstances, covers revision of a previous bariatric procedure when the patient has not lost adequate weight. At best, you'll need mounds of documentation to show the surgery is medically necessary for you. Hutcher compares submitting a claim for bariatric surgery to playing roulette: "And in roulette, you know the house always wins," he says. So why do health insurers seem to fail to see the cost-effectiveness in paying for surgery versus paying for years and years of treating related conditions? You will probably need to provide further documentation of your need for the surgery as medically necessary.


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Insurance Information - Weight Loss Surgery - Avera Health


Getting insurance approval for weight loss surgery can be a long frustrating process. The following information will be useful in helping you to get approved for your surgery. Call your insurance company and find out if they will pay for weight loss surgery and the follow up care for your procedure. After your surgeon submits all of your information to the insurance company for surgery approval, be your own best advocate. You do have options for weight loss surgery if insurance will not cover it.


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Insurance Information - BMI of Texas Weight Loss Center


Redefining healthcare by creating meaningful relationships and experiences with our patients and the community in order to overcome obesity and metabolic disease fostering improved health and a better quality of life. If you are like most people, you are probably extremely frustrated and tired of dealing with excess weight. Our comprehensive program will give you the tools you need to lose the weight you want and to keep it off. When it comes to Texas obesity surgery, it is our goal to not only help you achieve your weight loss goals but to improve your overall health and quality of life.


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Financing Weight Loss Surgery


But when you have a lot of weight to lose, and if exercise and diet aren't enough, you might consider weight loss surgery , also called bariatric surgery . You'll probably have questions about how much it costs, what insurance covers, and how to convince your insurance to cover the bill. Weight Loss and Health Care Reform. Weight loss surgery is expensive. The price of your weight loss surgery will depend on several factors: This will vary based on where you live, your surgeon's expertise, and the procedure’s complexity. Costs will vary and may include the operating and hospital rooms, among other fees. If you don’t have health insurance, you’ll likely have to pay the entire bill yourself. Some weight loss surgery centers can help you get a loan that you can repay over a number of years.


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Bariatric Surgery FAQs - American Society for Metabolic


How long after metabolic and bariatric surgery will I have to be out from work? You will have low energy for a while after surgery and may need to have some half days, or work every other day for your first week back. If you are on blood thinners of any type, expect special instructions just before and after surgery. When can I get pregnant after metabolic and bariatric surgery? You will have a lot of change between 6 and 18 months after surgery. Will I have to take vitamins and minerals after surgery? If my insurance company will not pay for the surgery, are payment plans available? Metabolic and Bariatric surgery is a health expense that you can deduct from your income tax. If you are not able to qualify for a loan, the Obesity Action Coalition (OAC) produces a helpful guide titled “Working with Your Insurance Provider – A Guide to Seeking Weight-loss Surgery.” This guide can help you work with your provider and advocate for your surgery to be covered. Will I have to go on a diet before I have surgery? Will I have to diet or exercise after the procedure? That is not the way people feel after surgery.


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Weight Loss Surgery Insurance


We have a team of insurance specialists to help you through the insurance maze. Insurance coverage is one of the biggest concerns among bariatric patients. The fact that your surgeon feels surgery is medically necessary and that you meet the surgical eligibility criteria does not automatically mean that your insurance company will pay for surgery. The surgical coverage benefit is primarily determined by the policy holder’s employer, not the insurance company. Even if you are in the initial stage of considering weight loss surgery, it may benefit you to know what to expect from your insurance company.


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Payment Options - Surgical Clinic of Louisiana


Many insurance carriers now offer a benefit for weight loss surgery procedures, but the coverage may vary based on your plan. Contact your insurance carriers' member services by calling the number listed on your insurance card. If the member services number is not listed, contact the person at work who manages your insurance policy for that information. The following are questions that you need to ask your insurance carrier before you submit your new patient packet if you plan to pay through insurance: If your insurance carrier covers weight loss surgery, ask them what procedures they will cover and what the criteria is for using your benefit. Your Insurance Carrier Does Not Provide Coverage. In this case, you do not have a benefit and your insurance company will not pay for any procedure. This means that when your employer selected an insurance company and a specific plan with specific benefits to provide health insurance to the employees, they did not choose to pay for, and include, weight loss surgery as a benefit in the overall plan. Unfortunately more and more people are finding it difficult or even impossible to use their health insurance to pay or help pay for weight loss surgery. Your personal bank, your Mortgage Company and now even online Internet financing companies can provide you with a good alternative to using your savings to pay for surgery. To get a quote on the costs involved for your surgery, contact our nurse coordinators at [email protected] or call our office at (504) 349­-6860.


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Obesity Action Coalition Insurance


Months (or years) of paperwork, initial exams, psychological counseling and insurance battles to get your weight-loss surgery (WLS) approved; then, the procedure. If you are in the planning stages of WLS, prepare. Persistence is critical to obtaining the WLS you and your doctor have decided is best for you. Life Insurance and Insurance Denials. If you are denied by a life insurance company, contact them and ask why. If you meet a life insurance company’s guidelines and are being turned down strictly because you had WLS, ask about an appeal process. Many brokers will be unwilling to negotiate for you, but if you show willingness to work and knowledge of the issue, you might find someone willing to work for you. If you have been denied either health or life insurance, follow this action plan in hopes of obtaining individual coverage and advocating on behalf of fellow WLS patients. Appeal the decision with the insurance company. Contact your state’s insurance commission and ask how to file a formal complaint. The individual state commissions typically give summarized versions of legislation in your state and might have resources that can help you locally. The National Association of Health Underwriters can provide more information about insurance brokers. Once there, click on your state and on the right, click “legislators.” Most state legislators are more accessible than members of Congress. Healthcare Reform Impact and Hope for the Future. The Web site is easy to read, has a frequently asked questions section, and will take you to a specific page about your state’s resources for high-risk pools.


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Bariatric surgery : Will your insurer pay


Bariatric surgery, which is commonly referred to as weight loss surgery, is a treatment that most insurers do not cover because insurance experts, insurers and doctors differ on the surgery’s classification. Hence, it is now known as metabolic and bariatric surgery. “The government has said that obesity is a disease and bariatric surgery is a non-cosmetic surgery,” said Dr. On 21 August, the Medical Council of India stated in a letter that “bariatric surgery is gastrointestinal non-cosmetic surgery under the rubric of surgical gastroenterology and not plastic surgery”. “We provide cover for bariatric surgery if it is done for medical purposes. We do a thorough due diligence and if proved that it is not for cosmetic reasons, we cover the surgery,” said Sanjay Datta, chief-underwriting and claims, ICICI Lombard General Insurance Co. Shalini Jadhav, a 32-year-old homemaker in Mumbai has insurance cover for bariatric surgery. I was suggested metabolic and bariatric surgery and underwent the surgery in February this year. So, it is also your responsibility to prove that the surgery was done for a medical condition to get a claim. “Normally, if the surgery is done for medical purposes and is prescribed by the doctor, then you can get mediclaim for the surgery.


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Weight Loss Surgery Insurance Coverage - SSM Weight


Your insurance provider will notify both our office and you at the same time regarding your approval status. If you have questions regarding the progress of your request, please contact your insurance provider. After you have received treatment at the SSM Health Weight Management Services, we will bill your insurance provider. We will bill the guarantor the balance once the claim is processed by your insurance provider. We may also seek assistance from the policy subscriber if we fail to receive a response from your insurance provider. Your insurance provider may require that you have prerequisite weight-loss treatments before allowing you to receive insurance coverage for surgery. If you're a member of a Managed Care Plan, your insurance provider may require that your Primary Care Physician (PCP), or plan provider, authorize any services. If you do not have health insurance, you will be billed directly for all services.


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Payment FAQ - Weight Loss Surgery in Houston TX


For many people, weight loss surgery is affordable because it is covered by their health insurance plan. Some patients pay for their own surgery and consider it a critical investment in their health. Many people find dealing with health insurance companies to be intimidating and are not sure how to even get started. Your best resource for how to deal with your health insurance company may be your weight loss program. New Start has weight loss coordinators who work on your behalf with your health insurance company. Write down your weight loss history. If possible, pull together receipts for gym memberships and weight loss programs. This documentation can be useful for your weight loss surgery program and health insurance company. If the insurance company turns down your request for lap band or other weight loss surgery, you may be able to appeal the decision. Work with Your Weight Loss Surgery Program. Our New Start program is designed to ensure that when the day of your surgery arrives, you'll be ready and in the best possible condition for a fast, healthy recovery. Choose a location to start finding out if weight loss surgery is right for you.


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Paying for Bariatric Surgery - Department of


If you are thinking about bariatric surgery and have doubts about whether it is right for you, you’re not alone. For many people, bariatric surgery is affordable because it is covered by their health insurance plan. People who do not have insurance coverage for bariatric surgery must pay for it on their own. Your best resource for how to deal with your health insurance company may be your bariatric program. Many bariatric programs have patient advocates who work on your behalf with your health insurance company. If the insurance company turns down your request for bariatric surgery, you may be able to appeal the decision. Work with Your Bariatric Program. It is critical that you work with your bariatric program to determine the correct approach to appealing a denial. This documentation can be useful for your bariatric program and health insurance company. If this is the case, there are steps you can take if your employer has decided not to include bariatric surgery as a covered benefit. Share your story and how you believe bariatric surgery will benefit not only you, but your organization as well. Take the time to educate your coworkers about the surgery and its importance. If you do not have health insurance and would like to have the surgery, you may want to explore alternative financing options.


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Sydney Lapband Surgery, Gastric Bypass and Branding Costs


If you have private health insurance you can end your weight-loss struggle for good for $5,950. Ring us on (02) 8197 9595 to discuss your options and costs if you do not have private health insurance. You will need to pay your hospital fees, but you may be surprised at how affordable this can be. The cost for the Gastric band , Gastric sleeve and Gastric Bypass is the same- we like it this way as it eliminates cost as a factor in deciding which is right for you. At OClinic we are very upfront about exactly how much your treatment will cost, with absolutely no hidden extras, and will provide you with a full written quotation so you know exactly where you stand. How do I know if my private Health Insurance will cover me for weight-loss surgery?


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Weight Loss Surgery Insurance Coverage - Bariatric Surgery


We have the answers to all your pressing questions about weight loss surgery and insurance. In general, the costs of weight loss surgery comprise anesthesia, the hospital facility and the surgeon's fee. And the weight loss surgery is likely not the last surgery you will undergo. Who Foots the Bill for Weight Loss Surgery? Insurance coverage for weight loss surgery varies by state and insurance provider. If you are considering weight loss surgery, the first step is to contact your insurance plan to find out if the procedure is covered and what, if any, caveats may exist. Medicare and Weight Loss Surgery. Medicaid and Weight Loss Surgery. Private Insurance Companies and Weight Loss Surgery. Many private insurance companies will cover weight loss surgery if your primary care doctor informs them that the surgery is medically necessary. Your chosen surgeon can be a partner and a resource in your quest to get your insurance carrier to cover your weight loss surgery. Parting Thoughts on Weight Loss Surgery and Insurance. Remember that it makes good financial sense for your insurer to foot the bill for your weight loss surgery. What's more, the cost of drugs for people with diabetes and high blood pressure plummet following weight loss surgery.


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How To Afford Weight Loss Surgery Without Insurance


When insurance coverage is denied and an appeal doesn’t work, patients often stress about how they’ll afford the cost of weight loss surgery . For some patients, bariatric surgery can be lifesaving, but it can also be expensive. Being denied insurance coverage for your bariatric surgery can be discouraging, especially when your health, or even your life, is on the line. But for the patients who look hard enough, bariatric surgery can be affordable. Loans are one option patients can turn to when they’ve been denied insurance coverage for bariatric surgery . This can increase the overall cost of their medical expenses. When budgeting for weight loss surgery, patients should consider all of the costs associated with it. The medical expenses of a bariatric procedure often include:  The hospital or bariatric surgical center where you choose to have your surgery performed may also offer payment plans. The cost of surgery for these self pay patients is often less than the cost of surgery for those patients who have been approved for insurance coverage for bariatric surgery , making the bill easier to swallow. Paying for the surgery by yourself can be tough, but the trade off can be great. With the right payment options, bariatric surgery can be affordable.


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My insurance won't pay for weight loss surgery, how can I


When you got the insurance, they usually give you a book that tells exactly what procedure are covered and under what circumstances. Or you can contact them and get a copy. However, if you can get your doctor to officially state something like "in my proffessional opinion, if she doesn't have this surgery, her life is in immediate danger"; they might have to cover it. You can only upload files of type PNG, JPG, or JPEG. You can only upload files of type 3 GP, 3 GPP, MP 4, MOV, AVI, MPG, MPEG, or RM. You can only upload photos smaller than 5 MB. You can only upload videos smaller than 600 MB. You can only upload a photo (png, jpg, jpeg) or a video (3gp, 3gpp, mp4, mov, avi, mpg, mpeg, rm). You can only upload a photo or a video.


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How Can I Get Gastric Bypass Paid For


If you know the answer to e question I'm asking, then answer it. Best Answer:  Well to start with, my wife had the operation and our insurance paid for it! Either the problem you are having with your insurance, is you either don't have any real life threats to your health at this time, or your doctor hasn't submitted a need for you to have the surgery because you don't have any immediate health problems and risks if you don't have the operation! Your doctor is the one who is suppose to tell the insurance company that you Need the operation because of health problems and issues, he's to make it clear to the insurance that the operation is very much needed, or else the insurance just see's it as a cosmetic operation. You should go to your medical assitance service, through your county and see if they can help you with the operation costs. If your doctor can prove to the county services that you need to have the operation, the county services may help you! I can understand why they would pay for gastric bypass surgery though, and I agree with that.assuming the people having surgery are real candidates and meet all the requirements. The surgery is a tool and how well that tool works is up to you! Make sure the reasons for the surgery are the right one. FOR YOU. A lot of doctors are quick to throw the surgery option in there these days, and you may not know what exactly you're getting into. You are probably aware that the surgery can fail to produce weight loss and get you into more trouble if the behaviors that got you into the position in the first place are unaddressed.


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Insurance Coverage for Weight Loss Surgery


If there is a policy exclusion for bariatric surgery your insurance company will NOT cover bariatric surgery under ANY circumstances. First step is to check for your benefits on your policy and your insurance requirements for authorizing the procedure. Our office will call your insurance company upon your instruction to verify benefits, approval requirements and pre-determination process. Once we obtain all documents and complete the package we will send all the information to your insurance company. It can take anywhere from 1 – 3 weeks for your insurance company to respond back and sometimes longer. As soon as we hear from the insurance we will contact you. If insurance needs additional documentation we will notify you and you then need to obtain the additional documentation necessary. However most appeals are denied unless you fulfill all the requirements by the insurance company and that we were able to provide documentation. You may call our office or your insurance company at anytime in order to check the status of your application. Our office will keep up with the insurance company in order to get expedited approval process on your behalf.


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Paying for Weight Loss Surgery


More people today are turning to bariatric or weight loss surgery , such as gastric bypass, lap band and the newer sleeve gastrectomy, for help losing large amounts of weight. According to the American Society for Metabolic & Bariatric Surgery (ASMBS), bariatric surgeries range from ,000 to ,000 and insurance coverage for these surgeries is far from guaranteed. “It’s all over the map from payer to payer with regard to what is or is not covered for bariatric surgery,” says Nancy J. Birkmeyer, Ph D, director of the Michigan Bariatric Surgery Collaborative at the University of Michigan Medical School. Medicare covers the cost of bariatric surgery for qualified patients as long as the surgery is conducted at a facility approved by the Centers for Medicare and Medicaid Services (CMS). Recently, the FDA expanded eligibility for lap band surgery, lowering the BMI requirement to 30 with one obesity-related medical condition. After the Surgery. “You have to have skin break-down problems — rashes and infections — or some medical reason as to why you have to have the skin removed.” Even if your benefit plan covers bariatric surgery, don’t be surprised if you have to fight hard to get the coverage approved. Join the discussion: Should insurers pay for weight loss surgery? The opinions expressed in the Web MD Blogs are of the author and the author alone. They do not reflect the opinions of Web MD and they have not been reviewed by a Web MD physician or any member of the Web MD editorial staff for accuracy, balance or objectivity. The opinions expressed in Web MD Second Opinion are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of Web MD Second Opinion are not reviewed by a Web MD physician or any member of the Web MD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions.


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Bariatric Weight Loss Surgery Costs, Insurance


What bariatric surgery procedures are covered? May I have a copy of the Medical Policy statement for bariatric surgery insurance coverage? What is the annual deductible, if any, and how much have I met so far? Here’s how: Let’s say you have already met $875 of your $1,000 annual deductible, and your insurance plan year begins (renews) on August 1. If you have surgery on August 2, you would again be responsible for the $1,000 deductible amount, instead of the remaining $125 from the previous year. Every year we see a heightened interest in bariatric surgery in November or December because people have met their deductible and want surgery before the new year when their insurance renews. People who are considering weight loss surgery and want to take advantage of the lower insurance deductible should start the process early enough to ensure that they can get surgery by the new calendar year. It is a way to make sure the procedure is covered under your Bariatric Surgery Insurance policy. What are some of the most common bariatric insurance coverage requirements? Some of the most common bariatric insurance coverage requirements include: What if my insurance provider denies the coverage? The surgeon’s office will be notified of the denial of coverage and will assist with you the appeal process if you choose to appeal.


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Read about bariatric surgery insurance


We can’t tell you whether your insurance covers surgery, but on this page we will explain how to work with your insurance provider to see if you have bariatric surgery insurance coverage. Step 1: Find out if you have coverage for bariatric surgery. May I have a copy of the Medical Policy statement for bariatric surgery insurance coverage? You have the right to access this information under most insurance agreements. Step 2: If surgery is covered, work with your bariatric practice to gather all the required documentation for pre-approval. Typically, your surgeon's office will submit the required information to your insurance provider to gain pre-approval. Check in with your bariatric practice to ensure that they submitted your information, or follow up with your insurance company in about a week if you submitted materials yourself. Ask your insurance provider for specific reasons. Call the member services phone number listed on your insurance card. You will also need to know your group number, which is also on the insurance card. You may want to consider working with your bariatric practice to discuss the next steps in appealing for coverage. Find the number for your state below. Lastly, you can try calling your state insurance department to register a complaint.


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Will my insurance cover it? - Lap Band Doctors


Lap band Surgery Will my insurance cover it? “You’re About To Learn 38 Guarded Secrets That Most People with Insurance Never Know About How To Really Get Your Insurance company To Pay for Weight Loss Surgery…” When you place your order for “Lap Band Insurance Secrets” you’ll discover secrets like… How to use scientific medical references so your insurance company will pay for your weight loss surgery. How not to fall for insurance company tricks and not get your authorization for weight loss surgery automatically denied. Click here to order Lap Band Insurance Secrets for only $9. The Lap Band Insurance Secret system is yours to try for 60 days. On the other hand, if our system helps you get your insurance to pay for your Lap Band weight loss surgery, we want you to email us to tell us your success story or testimonial – and please tell all our friends about it too! How to overturn insurance company decisions and get them to pay even if they give you a denial and refuse to cover weight loss surgery! Discover the one thing that many insurance companies look for to determine if they will approve you for bariatric surgery. The techniques we disclose in Lap Band Insurance Secrets has already worked for us in personally getting over 1,000 people in the U. S to have their insurance pay for their weight loss surgery.


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