Paying For Bariatric Surgery
Our goal is for you to have a pleasant experience throughout your weight-loss journey. We want you to have all of the information you need regarding your financial responsibility and insurance coverage.
Self-Pay and Financing
If your insurance doesn’t cover bariatric surgery, or if we do not participate with your provider, we will discuss alternate financial options with you. We participate with Advance Care, a health care finance company offering low monthly payments for bariatric services.
Insurance
We participate in most major insurance plans including Medicare. If your policy does not cover bariatric surgery, or if we do not participate with your insurance carrier, we will inform you of this and review alternative payment options. We are proud to be one of few bariatric programs in the state that does not have a program fee for our patients.
We are a designated Center of Excellence for the following insurance carriers:
- Aetna Bariatric IOQ network
- OptumHealth Care Solutions (formerly United Resource Networks)
- Blue Distinction Centers for Bariatric Surgery Program (Blue Cross Blue Shield Association)
Calculate Your BMI
Insurance providers use your BMI as one of the major factors to assess whether you qualify for surgery. Generally, a BMI of 35 with health conditions or 40 without health conditions is considered appropriate for surgery.
Pre-Determination
Your insurance provider may require pre-determination in order to qualify a patient for bariatric coverage. We will coordinate eligibility pre-determination for our patients to include the following:
- Letter of Medical Necessity
- Psychological evaluation
- Specialist evaluations
The pre-determination process does not begin until we have received your clearance.
Co-Pays/Co-Insurances
A co-pay or co-insurance will be due at the time of your initial consultation.
Medical Tourism
Medical tourism or health tourism, as it relates to affordability and insurance, is a recent trend where people travel from the United States to third-world countries for medical treatments because of cost consideration.
Medical tourism carries a variety of risks.
- The quality of post-operative care can vary dramatically, depending on the hospital and country, and may differ from US standards.
- Traveling long distances soon after surgery can increase the risk of complications.
- Health facilities treating medical tourists may not have policies in place to deal with complaints made by dissatisfied patients.
- If there are complications, the patient may need to stay in the foreign country for longer than planned or if they have returned home, easy access for follow up care may be unavailable.
It is important to consider all risk-factors associated with medical tourism.