This is one of the most commonly asked question in our practice. Our answer: ‘Depends on your health care plan’. We know it is important for you to check with your insurance provider as insurance coverage for bariatric surgery varies considerably between companies. Dr. McEwen’s team will work with you and your insurance to obtain and help you understand their requirements. We also have an on-site employee, Jessica, who works with insurance companies on finding out what requirements you will need to meet to qualify for surgery.
Depending on your insurance carrier, they may require past health records related to your weight and any co-morbid conditions. Common insurance requirements are a psychological evaluation, surgical consultation, diet and exercise counseling and/or 3-6 months of medically supervised weight loss.
Most insurances require that you have a Body Mass Index (BMI) of 30 or above per National Institute of Health criteria requirements. If they are wanting to use insurance their insurance will have their own BMI requirements that they will have to meet in order to obtain authorization for surgery. If your BMI is above 55 for males, or 60 for a female we will have you work with our dietician on weight loss prior to surgery.
Dr. McEwen’s office and his team at Community Surgery Center Hamilton will work to make sure you take full advantage and maximize your coverage. We strive to help our patients fully understand what they need to achieve and how to do so.
Our psychologist meets with our patients for the standard evaluation and determine the standard qualifications required by insurance and medical association. Psychologist will determine and provide clearance for surgery if patient qualifies.
If your health care provider requires medically supervised weight loss, our dietitian will work with you to create a schedule that will track your weight-loss efforts and train your eating habits for when you get your LAP-BAND®. Missing a month during 3-6 months, will result in having to start from the start. It’s important to make every appointment a priority. If you’ve already been tracking your weight with general doctor, they could provide you with a medical note/records presenting your progress.
For personalized information on LAP-BAND surgery click here and ORBERA click here.
You can always ask your insurance if they cover any procedures for non-cosmetic weight-loss or our office will be more than happy to take care the research for you. To learn more, come to one of our monthly FREE info seminars or request a video seminar.
To learn more about Dr. McEwen and the Community Surgery Center Hamilton team visit our facebook page or call our office at 317-621-2500.
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