What insurance plans cover bariatric surgery?
Many health insurance plans, including Medicare and most Medicaid plans, cover bariatric surgery. However, health insurance plan coverage varies, so it's important to examine the coverage provided by your plan. Major plans that provide coverage include: Blue Cross/Blue Shield and Priority Health.
What questions should people ask their insurance provider?
*Knowing when your deductible renews can help you reduce your out-of-pocket costs. Here's how: Let's say you have already met $875 of your $1,000 annual deductible, and your insurance plan year begins (renews) on August 1. If you have surgery on August 2, you would again be responsible for the $1,000 deductible amount, instead of the remaining $125 from the previous year.
Is pre-approval necessary?
Pre-approval is sometimes required for weight loss surgery. It is a way to make sure the procedure is covered under your Bariatric Surgery Insurance policy. Typically, our surgeon's office will submit the required information to your insurance provider to gain pre-approval.
What are some of the most common bariatric insurance coverage requirements?
Some of the most common bariatric insurance coverage requirements include:
What if my insurance provider denies the coverage?
The surgeon’s office will be notified of the denial of coverage and will assist with you the appeal process if you choose to appeal.
What about Medicare? What does it cover?
Medicare covers all bariatric surgery procedures except the sleeve gastrectomy. Out-of-pocket costs are similar to any other inpatient hospitalization.
Are there payment plan options?
Yes. We partner with a professional financing firm that sets up payment plans. For more information, contact our program.
Are there full cash-pay options?
Yes, cash pay options at Saint Mary’s range from $14,000-$21,000 depending on the type of surgery you choose.
What if I live out-of-town or out-of-state?
We are happy to accommodate patients who come to us from out-of-town or out-of-state. We have a process in place to make it convenient for those who live out-of-town and we will work with you via phone and Internet. We will also partner with your local physician to complete pre-operative and post-operative appointments. Please contact us for specific details.