Will Insurance Cover My LAP-BAND Surgery?
Lap-Band surgery in Dallas is a procedure that sections off a part of your stomach with a silicon band in order to curb your appetite and to help you lose weight. This alternative to gastric bypass surgery is a very popular option for obese patients, but one of the most important aspects of the surgery is whether insurance covers it or not.
According to the Lap-Band system, over 80% of Lap-Band patients had some part or the entire procedure covered by their insurance company.
Patients are encouraged to refer to the policy package they receive after starting their new plan or paying the first premium. If they don't have a policy manual with them, the insurance administrator can answer any questions or provide a policy manual. The package will list the expenses that are covered through their policy, including any weight loss procedures - but some insurance plans will only cover these procedures fully if they're absolutely necessary for the patient's health. If the procedure isn't medically necessary, partial coverage may be available to cover visits before and after the Lap-Band surgery.
Certain providers in Texas cover procedures such as the Lap-Band procedure. The following providers are just some of those Texas providers who either fully or partially cover the Lap-Band procedure:
-United Healthcare
-Aetna
-Cigna
-Tricare
-Blue Cross/Blue Shield
Full Coverage Guidelines
In order to cover the Lap-Band surgery in full, your insurance company may require your surgeon to send a Letter of Medical Necessity. This letter will include information about your weight, which will let the insurance company know if you are classified as overweight, obese, or morbidly obese, body mass index, how long you've been overweight, what methods you have tried to lose weight, and any medical problems you have as a consequence of your weight. It is advised that you include problems you have with everyday activities, such as getting out of bed and walking. You will also need to include proof of any gym memberships or exercise classes you have attended while trying to slim down. Finally, one of the most important things you need to include is a detailed list of all of your visits with your doctor for weight-related issues.
To increase your chances of receiving full coverage, your doctor can send in statistics and success stories about Lap-Band surgeries.
To increase your chances of receiving full coverage, your doctor can send in statistics and success stories about Lap-Band surgeries.
You'll find that the authorization of the procedure can be a long process. You should try to have a copy of all of your records and documents easily accessible in case your provider asks for them again during the process.
Financial Aid?
In 2006, there was a National Coverage Determination published for bariatric and Lap-Band procedures by the Centers for Medicare and Medicaid Services, which states that the procedure could be covered through those policies. You should call your provider to check your coverage availability.
No Coverage?
After going through these questions, you should have more of an idea of whether or not your insurance company will cover your Lap-Band surgery. If your provider denies your claim, most clinics offer payment plans or loans to help with the cost.
According to the Lap-Band system, over 80% of Lap-Band patients had some part or the entire procedure covered by their insurance company.
Patients are encouraged to refer to the policy package they receive after starting their new plan or paying the first premium. If they don't have a policy manual with them, the insurance administrator can answer any questions or provide a policy manual. The package will list the expenses that are covered through their policy, including any weight loss procedures - but some insurance plans will only cover these procedures fully if they're absolutely necessary for the patient's health. If the procedure isn't medically necessary, partial coverage may be available to cover visits before and after the Lap-Band surgery.
Certain providers in Texas cover procedures such as the Lap-Band procedure. The following providers are just some of those Texas providers who either fully or partially cover the Lap-Band procedure:
-United Healthcare
-Aetna
-Cigna
-Tricare
-Blue Cross/Blue Shield
Full Coverage Guidelines
In order to cover the Lap-Band surgery in full, your insurance company may require your surgeon to send a Letter of Medical Necessity. This letter will include information about your weight, which will let the insurance company know if you are classified as overweight, obese, or morbidly obese, body mass index, how long you've been overweight, what methods you have tried to lose weight, and any medical problems you have as a consequence of your weight. It is advised that you include problems you have with everyday activities, such as getting out of bed and walking. You will also need to include proof of any gym memberships or exercise classes you have attended while trying to slim down. Finally, one of the most important things you need to include is a detailed list of all of your visits with your doctor for weight-related issues.
To increase your chances of receiving full coverage, your doctor can send in statistics and success stories about Lap-Band surgeries.
To increase your chances of receiving full coverage, your doctor can send in statistics and success stories about Lap-Band surgeries.
You'll find that the authorization of the procedure can be a long process. You should try to have a copy of all of your records and documents easily accessible in case your provider asks for them again during the process.
Financial Aid?
In 2006, there was a National Coverage Determination published for bariatric and Lap-Band procedures by the Centers for Medicare and Medicaid Services, which states that the procedure could be covered through those policies. You should call your provider to check your coverage availability.
No Coverage?
After going through these questions, you should have more of an idea of whether or not your insurance company will cover your Lap-Band surgery. If your provider denies your claim, most clinics offer payment plans or loans to help with the cost.
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