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Navigating insurance policies and figuring out all of the
charges surrounding
weight loss surgery can be a daunting task all by itself. We
have put together some answers to the most common questions below.
As always, if you have further questions, please contact your
surgeon’s office or the Center for Weight Management at 1 (800)
823-6525.
Does insurance cover
weight loss surgery?
Many insurance plans
will help cover the costs of
weight loss surgery, but coverage varies according to your
medical history and individual insurance benefits of your policy.
If you would like to begin researching your options, you may call
your insurance provider and ask them if weight loss surgery is a
covered benefit under your specific company policy.
Ask for a description of your benefits related to weight loss
surgery in general and if only specific procedures are covered.
Also, your company may offer different plans from different
companies, some of which may cover surgery and some which may not.
If your current insurance policy does not cover weight loss surgery,
contact your human resources department to see if there is another
policy that does.
How quickly will my insurance
company approve me for surgery?
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All insurance companies
have criteria that you must meet before they will
approve you for surgery. This criteria may
include:
-
Proof that you are at least
100 lbs overweight or
-
Proof that you have a BMI
of 40 or above or
-
Proof that if your BMI is
between 35 and 40 that you
have documented
co-morbidities (like
diabetes, sleep
apnea or other conditions)
-
Some may require a 6 to 12
month record of
unsuccessful,
medically-supervised weight
loss
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Does St. Francis work with
insurance companies?
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My insurance company does not cover weight loss
surgery. What else can I do?
If your
insurance company or specific company policy
does not cover weight loss surgery, you may opt
to pay for it yourself. There are several
financial institutions that provide healthcare
financing for weight loss surgery – contact our
office at 1(800) 823-6525 for more information
I am
planning on paying for the surgery myself.
How much does it cost?
Cost for LAP-BAND or Sleeve
Gastrectomy surgery
For
self-pay patients, the St.
Francis Center for Weight
Management is offering the most
competitive packaged price for
LAP-BAND or Sleeve Gastrectomy
surgery in the Pacific
Northwest: $13,000.00.
This price includes:
-
surgeon's surgical fee
-
surgical assistant fee
-
hospital's surgical fee
-
anesthesiologist fee
-
nutritional counseling by a
registered dietitian
-
post-op visits for the first
90 days
-
your first 1-2 LAP-BAND
fills within the first 90
days after surgery
This price does not cover:
-
pre-op labs and exams to
qualify for surgery (your
insurance may cover these)
-
psychologist fee for
psychological evaluation
-
protein drinks and
nutritional supplements
-
additional LAP-BAND fills
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Cost for Gastric
Bypass surgery
There
are different types of Gastric Bypass surgery
and some are done via open surgery or using
laparoscopic techniques. Because there are
many variables, there is not a specific price
for Gastric Bypass, however, you can expect to
pay somewhere between $20,000 and $25,000 for
all of your services. Discuss this with
your surgeon to get a better idea of the total
cost for the specific type of Gastric Bypass
surgery you choose.
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Is there any benefit
to paying for it myself?
Other than not
having to wait for insurance approval, obesity is
recognized as a medical disease so the Internal Revenue
Service has deemed that out-of-pocket costs for a
physician-directed weight loss programs are tax
deductible.
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This is all too confusing. What should
I do?
If you have more questions about paying
for weight loss surgery through insurance,
or by paying for it yourself, please feel
free to contact the Center for Weight
Management at 1 (800) 823-6525. |
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