Will Insurance Cover my Weight Loss Surgery?
Insurance coverage and the cost of weight loss surgery are perhaps one of the greatest concerns for patients who consider surgical weight loss. The questions most patients ask are;
- Will my insurance cover it?
- And if not, how much is my procedure going to cost?
Texas Bariatric Specialists have a long standing belief that first and foremost a patient should consider the benefits of surgery, and then identify the procedure which will best serve them, prior to even worrying about insurance and cost. Mental and physical preparation for surgery should be the first consideration when evaluating surgical options. With that being said, money and financing cannot be overlooked. Through our “all-in-one” approach, Texas Bariatric Specialists significantly streamlines this entire process into one productive day.
- Upon registering for your new patient seminar/clinic you will be asked for your insurance information. *We will need you to register at least 3 days in advance of the seminar in order to have the time necessary to verify your insurance benefits prior to your visit.
- At your one-on-one consultation with the surgeon, we will review whether or not you have the benefit of weight loss surgery, what your insurance plan requires you to do to prove medical necessity, and what your out-of-pocket expense will be if you pursue surgery.
- If your insurance plan does not cover weight loss surgery, your options will be discussed.
- Many patients consider visiting the surgeon a total waste of time if they have an exclusion for weight loss surgery with their insurance, or when surgery is not an option. Nothing is further from the truth, if you consider the value of visiting with a weight loss surgeon who offers medical and surgical weight loss surgery options, as well as consulting with a nutritionist who can help you improve your behavior related to eating. There are other options out there besides weight loss surgery, including medical weight loss. Additionally, things in the insurance environment and with your employer’s policies change constantly and Dr. Patel can advise you of what changes you need to look for, and other changes that you may be able to make in regards to coverage. One should never consider it a waste of time to visit with the surgeon and to be initiated into a program for your overall well-being even if the insurance company says no to covering surgery.
- Once you have met with Dr. Patel or Dr. Reddy you will be assigned an Insurance Advocate. The insurance advocate will help you understand your insurance requirements and the timeline in which you are going to be able to achieve surgery.
- Physician Supervised Diet Programs- Many insurance programs can require a 3 to 12 month weight loss process prior to weight loss surgery. Typically, you can complete these visits in one of our offices. If that’s not possible, then you should be attending these monthly visits with your primary care physician and a member of our staff will contact you at least once a month by phone, email or via text using Klara (a secure healthcare communication platform) to help you keep on track. Once you are an established patient, you can reach us using Klara anytime you would like to communicate with the office.
- Based on the discussions that you have had with Dr. Patel or Dr. Reddy regarding your insurance plan’s bariatric benefits, your out-of-pocket expenses, and a timeline within which your surgery should be approved are not being met by your standards, you are encouraged to email Dr. Patel by using this form. This individualized attention given by Dr. Patel is a hallmark of the practice from the time of its initiation and now even with hundreds of patients in the pipeline. We offer this unique one-on-one level of access and you are highly encouraged to stay in touch with Dr. Patel or Dr. Reddy at any point your case is not being addressed to your satisfaction.
- Call your insurance company for you and verify if your company offers the benefit.
- Walks you ‘step-by-step through all the things that the insurance company will require you to do if coverage is available.
- Assist in financing options if insurance coverage is not available.
Many insurers will cover your weight loss surgery, however it is difficult to achieve insurance authorization on your own. This is why we assign each patient an insurance advocate to stream-line this process. Insurance coverage varies from patient to patient and employer to employer. This is why it is important to work with a specialist.
We accept all private insurances. Both ‘in-network’ and ‘out-of-network’ insurance plans are accepted. Please call us for details as all provider lists are not always complete or up to date. We unfortunately do NOT accept Medicaid at this time.