Interested to find out if your insurance addresses your surgery? Contact Us we shall find out for you! Bariatric surgery is covered by many insurance policies, and the amount which it costs depends upon the type of policy and its terms, as well as any contractual arrangement with a healthcare facility.
Insurance coverages come in many different kinds, and coverages can’t be forecasted really, since they vary from policy to plan, when released by the same insurance company even. If you wish to contact us for evaluation and surgery, we perform the insurance authorization and approval process at no cost. With specific policy approval and information, we can buy your out-of-pocket expected costs before you schedule surgery.
Many patients choose to cover the operation themselves. We offer special packages for cash patients, such as all usual services, at a substantial discount. The actual rate varies, with respect to the type of surgery chosen, and initial health insurance and weight status. It is best to remember that insurance companies make money, and profits, by collecting premiums – that’s their business. Every bit of care you receive, and that they have to pay for, decreases their revenue. Indemnity Plans (the type where they pay 80% and also you pay 20%) will often cover surgery for medically necessary treatment of medically severe obesity. Preferred Provider Organizations (PPO) often covers surgery, when necessary medically.
They want one to stay in their network, since it costs them less. This also means they could contract with a cosmetic surgeon that has little if any experience in bariatric surgery, because it costs them less. Managed Care Organizations of varied forms, such as HMOs, will attempt to avoid coverage of bariatric surgery usually.
- Baby Carrots
- Whole-grain breads
- Pack your lunches for either work or outings, and make sure they’re healthy
- Class 3 Obesity or 40+BMI (Body Mass Index)
- Sexual dysfunction
They usually have a “primary care” doctor, known as a “gatekeeper” also, who is supposed to evaluate your need for expensive surgeries — and he often suffers a financial loss if he suggests it. Medicare covers weight-loss surgery under certain specific criteria, that they use to determine if it’s clinically necessary.
The most important criterion, which must be fulfilled, is that one must be disabled for work completely, or from ordinary activities of daily living. MediCal will not cover this type of surgery, and will not pay the physician who performs it. As you might above have noticed, the necessity for surgery, and the coverage by insurance, usually depends upon the dedication that surgery is essential to improve health medically, to reduce dangers to life, and to permit a normal lifestyle. It depends upon the dedication of the individual seeking care also, in developing the arguments for medical procedures, and in accumulating corroborating information, and physician opinions, to substantiate the medical necessity.
The process of getting coverage involves several steps, and various strategies, dependant on the type of insurance, and the specific procedures of the insurance provider. The Medical History A thorough Medical History must be obtained, where the specific span of development of serious weight problems is made clear, current weight and height are measured, and Body Mass Index is determined.
The efforts to accomplish weight control by non-surgical methods are explained in detail, and each of the specific co-morbidities with which you are afflicted are characterized and identified. From this past history, an in depth picture of current health status, and the undesireable effects of obesity can be demonstrated. Supporting Documentation A brief letter from physicians who’ve treated you, especially specialists who have looked after a weight-related medical condition, can be quite valuable.