Verify Insurance Coverage
Many insurance companies cover weight loss surgery, but insurance coverage depends on your individual insurance plan. To qualify for any weight loss procedure, you must be at least 18 years old and have a Body Mass Index (BMI) of 40 or higher. Patients with a BMI from 35-39.9 with a major, weight-related health issue (i.e. Diabetes, High Cholesterol, Hypertension, Sleep Apnea) may also qualify for surgery. A care team member will meet with you at your first appointment to go through coverage and necessary requirements for bariatric surgery.
Insurance Coverage Checklist
Before working with our insurance coordinator, we highly recommend contacting your insurance provider to verify your bariatric surgery coverage and any plan limitations. Here are some common questions you can ask:
- Is bariatric surgery covered on my insurance plan or is it an exclusion?
- What requirements do I need to meet to qualify for surgery?
- What is my deductible? What is my out of pocket costs? Is my deductible applied to my out of pocket?
- What CPT codes are covered by my insurance for bariatric weight loss surgery?
- What type of weight-loss documentation do I need to qualify for surgery?
- Do I need a pre-surgery psychiatric evaluation? Is this covered?
Please document the date, time, and name of individual you speak with at your insurance company, as well as the information they provide you.
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