Many insurance plans, including Medicare and Medicaid, cover weight loss surgery. However, insurance plan coverage varies, so it is important to examine the coverage provided by your plan.
At a seminar you will learn more about how to find out the answers to your coverage questions, but you can also contact your insurance carrier to find more information about your coverage by asking the following questions:
1. Is bariatric surgery, or weight loss surgery, a covered procedure under my plan?
2. What procedures, specifically, are covered?
3. What are the coverage requirements for my plan?
Some common coverage requirements may include:
- Body mass index (BMI) greater than 40 or BMI greater than 35 with obesity related health issues. Find out what your BMI is here.
- Participation in a physician supervised diet and exercise plan.
4. What are my appeal rights if coverage is denied by my plan?
If you do not have coverage for weight loss surgery, there may be several financing options for you. We will help you navigate your way through the system of finding out what is available and reasonable for you.
You may consider our Cash-Pay Options:
1. If you have a BMI of 30-35, insurances will not cover your procedure. However, according to the American Society for Metabolic and Bariatric Surgery (ASMBS), you can still have a bariatric procedure to help prevent your pre co-morbid conditions from turning into conditions.
2. If your insurance plan deductible or out-of-pocket is too much.
3. If bariatric surgery is not a covered benefit in your insurance plan.
Laparoscopic Sleeve Gastrectomy Cash-Pay Option - $11,000
Roux-en-Y Gastric Bypass Cash-Pay Option - $16,000
Cash Pay includes initial assessment, psychological evaluation, surgery, surgeon, assistant surgeon, anesthesia and a one-night hospital stay for Laparoscopic Sleeve Gastrectomy or a two-night hospital stay for Roux-en-Y Gastric Bypass. Patients choosing Cash Pay will need a psychological evaluation and medical clearances from physicians; must have a BMI greater than 30; and must pay in full prior to surgery. Cash option rates may exclude some diagnostic studies.
A deposit of $500 will be requested on your initial appointment to secure your cash price package. This will be credited to the total amount listed above. The remaining $15,500 will be collected prior to surgery.