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What If My Insurance Doesn’t Cover Weight Loss Surgery?

Insurance documents outline coverage of bariatric surgery or treatment exclusions for weight loss surgery

We often get the question “Why doesn’t my insurance cover bariatric or weight loss surgery?”

At MIIS Weight Loss Institute, we work with you one on one before you come in for a consultation to make sure that you have coverage for bariatric surgery. The last thing we want to do is bring you in and get you excited about weight loss surgery only to find out that your insurance isn’t going to cover surgery. So, part of what we do before you come in for your consultation, is a verification check to make sure that your particular insurance policy covers surgery. There are times when we get the verification back and unfortunately there are no benefits for bariatric surgery. What happens then we give you a call and let you know.

The next question you may ask is “Why doesn’t my policy cover weight loss surgery?” Unfortunately, most of the time it has to do with the employer. The employer chooses whether or not they are going cover bariatric surgery on the policy. So, for any patient who has insurance through their employer, and we get that verification back showing no insurance benefits for surgery, that’s usually the primary reason. It’s just not part of the employer’s plan.   Unfortunately, most Marketplace plans do not cover bariatric surgery either.

Most insurance companies do cover bariatric surgery but there are certain criteria you have to meet. So, we walk this together on the phone.  We address if you meet criteria for weight loss surgery and if your insurance covers you under the rules and guidelines that we have to follow. Once determined, we schedule you for a consultation with our surgeon.

If we discover that your benefits do not cover weight loss surgery, then we discuss some additional options for you. One option many patients choose is being a part of the self-pay program we have available here at MIIS Weight Loss Institute. We have a couple of different options as well – surgery at the surgery center or at the main hospital. The physician will discuss this with you during your consultation to determine which one is the best option for you.  We have worked very hard to make self-pay surgery financially accessible to patients who are unable to utilize their insurance.   In fact, our self-pay surgeries start at only $12,999 – the lowest in the region.

If self-pay surgery isn’t an option for you, another possible choice is to utilize our medical weight loss program. This is a non-surgical approach.  It is very affordable and a great option if you decide not to pursue weight loss surgery, don’t meet criteria for surgery or if you find your insurance does not cover bariatric surgery. our medical weight loss program is provided through our Bariatric Nurse Practitioner.  She guides you every step of the way.

Complete your request for a free insurance verification check here.  We look forward to talking with you soon!

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