At some point after you have spent a considerable amount of time exploring the option of weight loss surgery, you will need to determine how to pay for the procedure. A growing number of states have passed legislation that requires insurance companies to provide benefits for weight loss surgery but your employer may have chosen not to provide bariatric surgery as a benefit.
The best chance for obtaining approval for insurance coverage comes from working together with your surgeon, your insurance provider, and the bariatric navigator provided for you as part of our comprehensive bariatric center.
KEY STEPS YOU SHOULD TAKE TO OBTAIN INSURANCE COVERAGE FOR WEIGHT LOSS SURGERY
- Read and understand the certificate of coverage that your insurance company is required by law to give you. If you do not have one, consult your company’s benefits administrator or ask your insurance company directly. Your certificate of coverage will outline the steps required to obtain weight loss surgery coverage.
- For many insurance providers, you will be required to start with your primary care physician to obtain a referral. Even if you are not required to get a referral, it is a good idea to have the support of your primary care physician.
- Before visiting with your surgeon, organize your medical records, including your history of dieting efforts. They will be valuable documents to have at every stage of the approval process.
- Document every visit you make to a healthcare professional for obesity-related issues or visits to supervised weight loss programs. Document other weight loss attempts made through diet centers and fitness club memberships. Keep good records, including receipts. Many insurance companies require several months of documentation of physician-supervised weight loss efforts before considering approval for surgery.
- Some insurance providers require up to five years of office notes documenting obesity and up to two years of physician-supervised diets. A two to six-month physician-supervised weight loss regimen is more common. It is therefore important for your medical physician to clearly document medical weight loss efforts and discussions regarding your disease of obesity.
Once all of your insurance requirements have been completed, we will submit a formal request for authorization from your insurance company. Thirty days is the standard time for an insurance provider to respond to your request. We will notify you as soon as we receive your notification. Frequently, your insurance provider may notify you a couple of days before we receive a notification.
If your insurance policy does not offer coverage for weight loss surgery, there are heavily discounted options available for self-financing. The cost of a life-saving operation is less than the cost of a car. Your bariatric navigator is able to assist you with several financing options and can be reached at (706) 509-3055.