How to get weight loss surgery covered by insurance

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What insurance companies pay for weight loss surgery?

Coverage for weight-loss surgery varies widely, as do insurers’ definitions of “medically necessary.” Here’s information from two major insurers — Aetna and CIGNA.

How can I get insurance to cover bariatric surgery?

Speak with your human resources department – is your company self-insured? Find out if you meet their criteria. Make sure it is documented that you meet their criteria. Work with your surgeon/program to complete a peer-to-peer review if your company covers surgery and you meet the criteria.

Can gastric sleeve be covered by insurance?

Today most insurance companies that cover weight loss surgery will cover gastric bands, laparoscopic gastric bypass, and gastric sleeve surgery. Only a few years ago the lap band procedure was considered experimental and not covered by most insurance companies.

What is the minimum weight for bariatric surgery?

To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40).

What is the best weight loss surgery?

The three types of surgery included gastric bypass, sleeve gastrectomy and adjustable gastric banding (also known as lap band). The study found that gastric bypass surgery boasted the greatest weight loss — both short- and long-term.

How quickly can I get bariatric surgery?

The entire process, from consultation to surgery, generally takes about six months to complete. It often depends on you and your insurance requirements.

How do people afford weight loss surgery?

Many hospitals and medical practices offer plans that allow patients to pay their bills in instalments, rather than all at once, often without interest. Peer-to-peer loans. You can fund your weight loss surgery through a loan funded by investors, rather than financial institutions, using peer-to-peer lending options.

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How long does insurance approval Take for bariatric surgery?

It can take two to four weeks for the insurance company to respond with a decision. We will call you once we receive word from the insurance company of approval or denial. If the coverage is approved, a surgery date and pre-op appointment are scheduled for the patient.

What is the cheapest gastric surgery?

Self-Pay

  • Surgical Costs for Self-Pay Patients – Basic Packages.
  • LAP-BAND® Removal – As low as $2,200* Costs Included in LAP-BAND® REMOVAL:
  • LAP-BAND® – As low as $11,560* …
  • Gastric Sleeve – As low as $10,000* …
  • Gastric Bypass (RYGB) – As low as $15,500* …
  • Revisional Surgery. …
  • Balloon – Orbera® Intragastric – As low as $7,000*

What if my insurance doesn’t cover bariatric surgery?

If your employer-provided insurance plan doesn’t cover bariatric surgery, you may need to do some lobbying on your behalf, either with your company’s human resources department or your union reps, Wheeler says. “If you want these benefits added, go to HR, go to your employer and advocate for yourself,” Wheeler says.

Who is a good candidate for gastric sleeve surgery?

You typically qualify for bariatric surgery if you have a BMI of 35-39, with specific significant health problems like Type 2 diabetes, sleep apnea or high blood pressure. A BMI of 40 or higher also is a qualifying factor.

How long do you have to be off work after bariatric surgery?

As a guideline, both open and laparoscopic gastric bypass and sleeve surgery patients have about a 2-3 week recovery period, (although some can take as long as 6 weeks) before they can return to work. Open surgery patients generally take longer.

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Is the gastric sleeve worth it?

Gastric sleeve surgery is permanent and can lead to positive health outcomes for obese people who have struggled with achieving and maintaining weight loss. And overall, gastric sleeve is considered safe when compared to other commonly performed surgeries.

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