The actual costs of your bariatric surgery will depend on your individual situation, including things like your specific health plan and whether you will have an inpatient (overnight) or outpatient (same day) procedure.  That said, there may be many ways to cover the costs of your bariatric procedure, including insurance or private financing.  Based on market research, over 80% of actual bariatric cases performed were reimbursed in full or in part by insurance.

Insurance and Health Plans

Private insurance (HMO or PPO) will often cover some, if not all, of the costs of your bariatric procedure. Usually an approval is required before you can have the surgery.

To find out if your policy covers weight loss (or bariatric) surgery, refer to your policy materials. If you don’t have a copy, your employer’s human resources department or your insurance provider will be able to provide them for you. Read through your benefits, looking for:

  • Covered Expenses” (or similar title): the expenses your insurance company will pay.
  • What Is Not Covered” (or similar title): costs that may not be covered by your plan.
  • Any reference to coverage for weight control, or the treatment of obesity.

Some policies only cover the procedure when medically necessary. In this case, your surgery should be covered if you meet national guidelines for the care of morbid obesity.

You may also find the procedure is partially covered. This usually means your tests or hospital and anesthesia fees if you are having another approved abdominal surgery performed at the same time.

Authorization requirements

Most insurance companies require prior authorization for weight loss surgery, as well a Letter of Medical Necessity from your doctor. General Surgery of Southaven will help provide the Letter of Medical Necessity, as long as the following can be documented:

  • Your weight (at least 30 pounds overweight with one or more obesity related comorbid conditions) and your BMI (at least 40 kg/m2 or at least 30 kg/m2 with one or more obesity related comorbid conditions).
  • A list of any weight-related medical conditions you have.
  • The fact that you have been significantly overweight for five years or longer.
  • The number and type of weight loss programs you have tried.

Financing your Surgery

It’s unfortunate that some health plans will simply not cover your weight loss surgery, regardless of medical necessity. If this is the case, you should know there are many other ways to cover your Gastric Sleeve or LAP-BAND® System surgery. These include:

Out-of-pocket payment

If you have the financial freedom to do so, you may want to consider a lump sum payment. You may be surprised at how affordable the Gastric Sleeve or LAP-BAND® System surgery actually is! Call us today for more information: 662-536-1944

Institutional Loans

There are special medical financing companies that offer easy access and a full range of payment plans for bariatric surgery.

  • Dr. Fore has partnered with Prosper Healthcare Lending – the premier financing company in the bariatric surgery industry. With over $5 Billion funded and over 300,000 loan inquiries serviced through their lenders, this is a name and a program you can trust.Here are some of the benefits you’ll receive with a loan from Prosper HealthCare Lending:
    • Immediate decisions for loans under $35,000
    • Term options out to 84 months (affordable monthly payments)
    • No collateral required
    • No prepayment penalties
    • Fast & easy loan inquiry process
    • 100% Confidential
  • Care Credit Patient Financing Program – Dr. Fore also participates in an exclusive program that links patients to CareCredit®, a GE Money company.

CareCredit® is the nation’s leading patient financing program. It has helped over 6 million patients worldwide get the treatment they need. The LAP-BAND® System Patient Financing Program helps patients cover healthcare expenses not covered by insurance by offering:

  • Up to 100% financing of medical fees — from $1,000 to $25,000.
  • Financing of co-payments or deductibles.
  • High approval rates & instant approval notification.
  • Low interest payment plans — up to 60 months.
  • Convenient monthly payments.

To apply:
Apply online at www.carecredit.com or call 1-800-677-0718 to apply by phone.

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