The insurance company will then review your case. The letter will outline your medical history and health problems related to your weight, and provide documentation that you have completed all requirements for approval. When you have completed these steps, the surgeon will send a preauthorization request letter to your insurance company. You will work one-on-one with a nutritionist to outline specific dietary changes and habits that need to be changed. The psychological evaluation also checks for untreated binge eating or any other psychological issues. This is to make sure that you understand weight loss surgery and the impact it will have on your lifestyle. They want you to demonstrate over the 6 months prior to surgery that you can commit to lifestyle changes you’ll need to make forever after your weight loss surgery. In fact, most insurance companies require that the patient's weight be stable during this time - with no up-and-down fluctuations - or you may be denied coverage. The insurance companies aren’t trying to find out if you can lose weight through dieting. This type of diet program involves monthly visits to your doctor or bariatric surgeon's office for 6 months. Medicare does not require this 6-month program, but you may be encouraged to participate anyway. You may be required to successfully complete a 6-month weight-loss program before approval is granted. Participation in a physician-supervised diet program.Your surgeon can help provide your medical history and documentation of your weight-related health problems. Proof that surgery or medical intervention is medically necessary.Most major insurance companies will require: Getting Your Insurance to Pay for Weight Loss Surgery Some weight loss surgery centers can help you get a loan that you can repay over a number of years. If you don’t have health insurance, have insurance through a large employer (50 or more employees), or you live in a state that does not include bariatric surgery in its essential health benefits, you’ll likely have to pay the entire bill yourself. Most insurance companies recognize that people who are overweight and obese are more likely to get serious health conditions such as type 2 diabetes, high blood pressure, heart disease, high cholesterol, and sleep apnea. Under the Affordable Care Act, some states require that health insurers selling plans in the Marketplace or directly to individuals or small groups cover bariatric surgery by 2016 nearly half of states mandated coverage for these plans. If you have health insurance, read your policy carefully, and work closely with your insurer and your doctor to see what's covered. Follow-up procedures (for the gastric band).Costs will vary and may include the operating and hospital rooms, among other fees. This will vary based on where you live, your surgeon's expertise, and the procedure’s complexity. Other options include intragastric balloons or even an electric Implant device. Types of weight loss surgery include gastric bypass, adjustable gastric banding, vertical gastric banding (also called stomach stapling), sleeve gastrectomy, and biliopancreatic diversion. The price of your weight loss surgery will depend on several factors: Typical costs can run from $20,000 to $25,000, according to the National Institute of Diabetes and Digestive and Kidney Diseases. You'll probably have questions about how much it costs, what insurance covers, and how to convince your insurance to cover the bill. But when you have a lot of weight to lose, and if exercise and diet aren't enough, you might consider weight loss surgery, also called bariatric surgery.
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