bariatrics

Insurance Information

It is very helpful to contact your insurance company before considering weight-loss surgery to ensure you fully understand your responsibilities for payment.

You should contact your insurer to learn:

  • If the type of procedure you are considering is covered by your plan
  • How much you will be responsible to pay and if there are any deductibles
  • If our hospital and surgeons are a part of your coverage
  • If your insurance provider requires documentation of medical attempts to lose weight prior to surgery

Some companies require three to six months of documented weight-loss attempts. If this is the case, speak with your primary care physician first to complete the necessary documentation.

This documentation may include:

  • Current dietary program
  • Current exercise program and recommendations
  • Lifestyle changes
  • Use of prescription weight-loss drugs where appropriate
  • Vital signs including weight

Other requirements may include:

  • A psychological evaluation to make sure you clearly understand what to expect with weight loss surgery and the impact it will have on your lifestyle
  • Checking for untreated binge-eating or other psychological issues related to weight
  • A nutritional evaluation to outline specific dietary changes and habits that will need to be modified

In most cases, to qualify for insurance coverage you must have at least one of the following:

  • A body mass index (BMI) greater or equal to 40
  • You may also be a candidate if your BMI is between 35 and 39 and you have at least one other major medical condition (comorbidity) such as:
    • Respiratory problems (sleep apnea or hypoventilation syndrome)
    • Hypertension
    • High blood pressure
    • Severe arthritis
    • Diabetes

These are just general guidelines of what your insurance company may require, and they may vary according to the specifics of your plan.

Information for those without insurance coverage

If you do not have coverage for weight loss surgery, you can still proceed with the surgery through our self-pay/paying out-of-pocket option. Contact us to inquire about rates.