Health Insurance Coverage
One of the main concerns for many people when considering weight loss surgery is cost. When dealing with health insurance companies, the process can often seem long and complicated. We are here to make it easier. Our office has bariatric coordinators who will assist you in all steps of getting through the weight loss process, including guiding you through the insurance approval process.
If you don’t have insurance, we will go over several options for you including cash pay discounts and ways to obtain loans if necessary. There is truly no better investment you can make than in your own health. Most studies show the cost of the surgery is offset on average in as little as two years just in the savings in decreased medications, decreased hospitalizations, decreased doctor visits, etc.
If you have health insurance, the first thing to do is to confirm whether you have coverage for bariatric surgery or not. You should call the customer service number on the back of your insurance card. Ask if bariatric surgery is a covered benefit. Get a copy of your policy in writing.
Q: Who do I call to confirm that my insurance covers weight loss (bariatric) surgery?
If your insurance provider indicates that you have coverage “if it is deemed medically necessary,” this means that you have benefits for weight loss surgery. The insurance experts at our office will verify the specific benefits you have and will go over all of the specifics about your insurance coverage and the requirements for approval for surgery when you meet with us at your first consultation with your surgeon.
If your insurance provider indicates that you have “exclusion” on your policy, this means that your employer has opted not to cover this benefit for employees. Unfortunately, if you have an exclusion, letters or appeals from our office will not change whether or not you have this benefit on your policy. Only your employer can make this change by choosing to cover bariatric surgery as a benefit to their employees.
If you have an exclusion, we recommend that you to speak with your human resources director and ask if there may be plans to cover this benefit in the coming year. We have had several patients in our program convince their employers that the benefits of weight loss surgery – including getting off of their expensive medications rather quickly, missing less time off from work due to related conditions and illnesses, and generally being more productive due to a more positive outlook on life – outweighed the cost to cover the benefit, and they were successful in gaining coverage.
Q: How much does the surgery cost if my insurance will not pay for it?
Cost variables exist with each procedure and we will give you specific pricing at your initial visit or at the informational seminar. If you are paying for the surgery outside of insurance, the costs of the procedure starts as low as $9999 for the lap band and $14,500 for the lap sleeve if the procedures can be done at the outpatient surgery center. Keep in mind that these costs include the surgeon fee, the hospital fee following surgery, all operating room time, nursing staff, supplies, instruments, medications, anesthesia fee, and your anesthesia team. It also includes your first 90 days of follow-up appointments for all bariatric procedures.
* discounted pricing does not apply to patients using Care Credit or United Medical Credit. If the procedures are done at the hospital, cost start around $12,000 and go up to $18,000, depending on the procedure. These costs will include the surgeon fee, the hospital fee following surgery, all operating room time, nursing staff, supplies, instruments, medications, Anesthesia fee, and your anesthesia team. It also includes your first 6-months of follow-up appointments.
For financing options, we recommend contacting CareCredit or Prosper Lending. You can apply for a loan through either patient financing institution to help you afford the cost of surgery.
How CareCredit™ Works
Atlanta Bariatrics at Johns Creek Surgery accepts CareCredit. With CareCredit, you can pay for out of pocket expenses for your weight loss surgery right away and then make convenient monthly payments.
Make Healthcare Affordable™
Prosper Healthcare Lending is the premier financing option for healthcare procedures. The healthcare financing industry has been flooded with high-interest credit cards that may help you pay for the treatment you need, but often end up causing more harm than good. Financing through Prosper Healthcare Lending offers healthy, simple interest loans with no prepayment penalties, no retroactive interest, longer terms for lower monthly payments, and an inquiry process that will only take you minutes to complete. We truly “Make Healthcare Affordable.”