Weight Loss Surgery Insurance and Financing

Volumes of medical data demonstrate the health benefits and cost effectiveness of bariatric surgery, but health insurers remain generally resistant to providing coverage for bariatric surgery. The reasons for this perplexing situation are complex and not fully understood, but the current situation is that coverage for medically appropriate surgery is spotty. Often, when surgery is available as a covered benefit it is supported only after a patient clears a number of administrative “hurdles” that the insurer uses to reduce accessibility, such as requiring a six-month diet, a five-year weight history, etc.

We are hopeful that additional data now being gathered will help health insurers decide to improve coverage of medically necessary treatment such as bariatric surgery. In the meantime, we advise patients to be vocal and persistent in seeking insurance funding for the healthcare they need. This usually means taking the issue to the HR department at your workplace. Acadiana Weight Loss Surgery strongly encourages anyone with access to health insurance funding to pursue that option.

Patients should contact their health insurer directly and as early as possible in the process of surgical preparation. As an individual with health insurance coverage, you are a customer with the right to require information and service from that company. If you are told by your health insurer that bariatric surgery is not covered, don’t be put off or discouraged. We often find that erroneous information is conveyed if questions are not posed in an exact manner. If you have attended our informational seminar and become interested in pursuing surgery, our staff will assist in your efforts to obtain insurance approval. Patients who actively participate in the insurance pre-authorization process by calling and inquiring with their insurance company are a significant stimulus for insurance companies to respond favorably.

For patients who are covered by insurance, Acadiana Weight Loss Surgery will bill the insurance company directly; however, most patients are responsible for co-payments at the time of initial consultation and for deposits prior to surgery. Anticipated co-pays for the surgical procedure itself must be paid by the patient at the time of the pre-operative preparation appointment, usually about one week prior to surgery.

Employers who invest in the long-term health and functionality of the workforce should see the inclusion of a bariatric surgery benefit as a favorable move for their company. Patients may be able to affect an employer’s benefit plan by working with their employer’s benefits department to include treatment of morbid obesity. To assist in such an effort, any of the Acadiana Weight Loss surgeons are available to speak directly with any employer who is considering including bariatric surgery as part of their wellness and weight management plan.

For patients who do not have access to insurance coverage and who wish to utilize the “self or cash pay” option, Acadiana Weight Loss Surgery and some of the hospitals with which we work each have created a single lump-sum, fixed-fee schedule for bariatric surgery. The fixed rate we have arranged means that a patient can know with reasonable certainty what their surgery is going to cost before it happens.

The rates for the several facilities at which we operate change with some regularity. If you are interested in this option, please discuss current costs with the administrative coordinator at Acadiana Weight Loss Surgery.

Acadiana Weight Loss Surgery offers several financing options to assist you in obtaining the necessary funds for the payment of surgery fees.

Apply Online at: ProsperHealthcare.com or MedLoanFinance.com