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One of the most complex aspects of bariatric surgery is understanding insurance coverage and financing options. We want to help you successfully navigate these often frustrating and complicated options.
Most insurance providers accept bariatric surgery as a viable treatment option for obesity. There are important considerations when working with your insurance company:
While the insurance company may have policies that cover bariatric surgery, individual plans may not. Contact your insurance provider to understand your coverage details.
If bariatric surgery is covered, note which specific bariatric procedures are allowed under your plan. Your particular plan may not cover one or more types of surgery.
Note your deductibles, out-of-pocket expenses and specific exclusions regarding bariatric surgery. Verify that your deductible and out-of-pocket expenses are suitable for your financial situation.
We will verify your insurance benefits and submit all required documentation to your insurance company on your behalf, at no additional cost to you.
Insurance companies will typically require documentation of your history of weight loss attempts. In general, they will expect to see failed attempts at diet, exercise and medical weight loss programs for at least one year and will want to verify that bariatric surgery is a medial necessity. Your insurance company will review your preauthorization application and make a decision to either approve or deny.
Preauthorization is often denied due to errors or omissions. It is vital to speak with your insurance company to find out exactly why your claim has been denied. It’s often the case that a simple fix can be the difference between approval and denial. Insurance companies have an obligation to allow you to appeal a denial of coverage. Appeals are typically time consuming and require additional paperwork, but with persistence, you may be able to overturn your denial. Speak to your primary physician and our helpful staff in order to determine the best course of action. It’s often a long, time-consuming process, but if you’ve approved, the time spent will be well worth it.
In the event that your insurance policy will not cover bariatric surgery and you cannot self pay, third-party financing may be the best option. This could include an unsecured personal loan, credit card loans, a secured home equity loan or specific medical financing. Keep in mind that nearly all of these financing options come with financing and interest cost, in addition to the cost of surgery.
Credit Cards can be useful because any purchase in generally pre-approved as long as it remains within your credit limit. Be sure to fully understand the risk of using credit cards to finance your procedure as interest rates may be high or may change over the life of the loan.
A Home Equity Loan or collateralized loans come with interest and finance charges. It is crucial that you understand the consequences of default with these loans, which may include losing the collateralized assets—in some cases, your home. Interest rates often vary.
Third party medical credit can vary widely in interest rates and terms based on your creditworthiness. Be sure that you fully understand all repayment and cost terms.
If you cannot or do not want to use insurance or financing for your procedure, the option to self pay is available. If you are considering this option, we encourage you to contact Financial Assistance at 904-202-2092 for repayment options. We are typically able to combine the costs of surgery into one convenient package, making it easier for you.
The cost of weight loss surgery depends on the procedure being performed and the method of payment used. You can contact our office to learn more about payment and financing options, as well as an estimated cost of surgery. In most cases, the initial cost will cover:
Pre-operative Testing and Lab Work
Three Months of Post-Surgery Care
Insurance coverage varies depending on your plan. Speak to your insurance to determine deductibles, co-pays and any other out-of-pocket expenses. Be sure you know when your policy rolls over. Undergoing the procedure during the current coverage period may mean lower costs because some of the deductibles and out-of-pocket expenses may already have been met.
Most financing plans will come with an interest payment. To determine an accurate cost of surgery, financing costs must be considered as part of the overall cost. Please contact our Financial Assistance department at 904-202-2092 to discuss the available financing options.
Keep in mind that dietary consultation, supplementation and physical therapy needed after the three-month aftercare period may not be covered by your insurance or under the initial cost of surgery. Some of these costs may include adjustments and band fill for the Lap-Band® or Realize® Band systems.
Bariatric surgery comes with a significant cost, but that cost may be paid back in the form of savings as a result of a healthier lifestyle with fewer trips to the doctor and reduction of prescription medication. A recent George Washington University study pegged the cost of obesity at more than $2,000 per year for obese men and more than $4,000 per year for obese women. The average patient with morbid obesity has annual health care costs averaging $5,000, and if they’re diabetic, nearly $8,000.
Although attending the seminar is required, it is the best way to get an in-depth explanation of the weight loss procedures and what you can expect before, during and after surgery.
I'm interested in learning about
Our free seminars are hosted by one of our board-certified bariatric surgeons. You'll learn about our three surgical options, next steps and get answers to your questions.
To register, select a location and date below
Baptist Medical Center Jacksonville, DuPont Auditorium
By attending a live seminar, you will meet our surgeons and get a more comprehensive understanding of bariatric surgery. But if you cannot attend in person, you may watch our online webinar.
Please call us for more information about starting your weight loss journey.