Bariatric surgery is covered by many insurance plans. However, the amount covered depends on the type of policy and its terms. The cost of the operation includes hospital charges, surgeon fees, surgical assistant fees, anesthesiologist fees, lab charges, X-ray charges and consultation fees. Insurance plan co-pays and deductibles vary, so it is important that you check with your insurance company directly.
Contact your insurance company to verify that your policy covers weight loss surgery. Specifically, you should ask if the following procedures are covered by your insurance plan:
After all of your consultations are completed with your primary care physician, it usually takes the physician’s office a few days to send a letter to your insurance carrier to start the approval process. The time it takes to get an answer can vary from three to four weeks or longer, if you are not persistent in your follow-up. It may be helpful for you to call the claims service of your insurance company about a week after your letter is submitted and ask about the status of your request.
Your wait will be dependent on whether you have already met the criteria for your insurance to cover your surgery. Typically, however, after you have attended one of our seminars, a one-on-one consultation can be scheduled with one of our surgeons within a week or two. Once you, your primary care physician and your surgeon agree that surgery is an appropriate option for you, the operation can usually be scheduled within four to eight weeks. This time is often necessary for insurance authorization and for you to have appropriate pre-surgical tests.
Most insurance companies require documentation of dieting and exercise program attempts. This includes formal documentation of items, such as a minimum of six months to one year of medically-supervised weight loss history (i.e., prescribed diet drugs, attempted diet plans and/or program records and documentation of exercise regimens).
Your insurance company will require official documentation for pre-determination, so you should begin gathering these records immediately. Simply listing these items on the initial patient questionnaire will not suffice. Your physician’s records are required.
Port Huron Hospital HealthAccess
1.800.228.1484 (Michigan Callers)
Port Huron Hospital
Bariatric Center of Michigan
Wismer 3rd Floor Clinic
1221 Pine Grove Avenue
Port Huron, MI 48060