Will My Insurance Cover Weight Loss Surgery?
Jessica Hatt, Insurance Specialist Bariatrics
Insurance is the most common asked question in our practice after safety of outpatient weight loss surgery. Jessica’s answer regarding insurance coverage, “It depends on your health care plan but most will.” It is very easy to check. We are happy to call and check. You can look at your insurance card, call member services and ask the following questions:
Do I have bariatric surgery coverage?
Do you cover CPT code 43770 (Gastric Banding)?
What is my requirements for Bariatric Surgery?
Most employers even have a website for a member to check benefits.
Always write down what the service person tells you and their name.
We will work with you and your insurance to obtain and help you understand their requirements.
Insurance carriers usually require the following which we will help you achieve or obtainL
1) Surgeon Consultation
2) 3-6 months of medically supervised weight loss documentation (we offer this)
3) A Body Mass Index (BMI) of 35 or above with health complications or a BMI of
30 for Lap Band System if you have diabetes, sleep apnea or cardiac issues.
If your BMI is above 40 you generally do not need to show proof of health
complications to qualify because your weight is considered morbidly obese m
meaning you could die from your weight with no additional health issues)
If you have a BMI under 35, it is unlikely that your insurance will cover the procedure but you still have the option to pay out of pocket.
To learn more about Dr. McEwen and Community Surgery Center Hamilton team visit our Facebook page or call our office at 317-621-2500.
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