Insurance & Financing for Bariatric Surgery
Bariatric surgery is a major financial commitment, and all of us here at the Baptist Center for Bariatrics are committed to helping you navigate the intricacies of financing your weight loss journey. Generally, there are three methods most commonly used to finance bariatric surgery: Insurance, Third-Party Financing and Self-Pay. Below you will find an overview of these methods.
As most insurance companies have recognized obesity as a disease, most providers accept bariatric surgery as a viable treatment option. That being said, there are some very important considerations when working with an insurance company:
- While the insurance company itself may have policies that cover bariatric surgery, individual plans may not. Contact your insurance provider to understand your coverage details.
- If bariatric surgery is covered, note which specific bariatric procedures are allowed under your plan. Your particular plan may not cover one or more types of surgery.
- Note your deductibles, out-of-pocket expenses and specific exclusions regarding bariatric surgery. Verify that your deductible and out-of-pocket expenses are suitable for your financial situation.
- We will verify your insurance benefits and submit all required documentation to your insurance company on your behalf, at no additional cost to you!
Insurance companies will require significant documentation and a prior history of attempts at weight loss in order to approve you. Generally speaking, insurance companies will expect to see failed attempts at diet, exercise and even medical weight loss programs for up to one year or more. They will also want to verify that bariatric surgery is a medical necessity for you. Once you have submitted a pre-authorization application to your insurance company, it is up to them to review your information. Once the insurance company has made a decision you'll either be approved (congratulations!) or denied.
What if my Bariatric Insurance Request is Denied?
Pre-authorization is often denied because of errors or omissions in the application and authorization process. It is therefore important to speak with your insurance company and find out exactly why your claim has been denied. Oftentimes, a simple fix or correction of an oversight can be the difference between approval and denial. Other times, a denial warrants an appeal. Insurance companies have an obligation to allow you to appeal a denial of coverage. Appeals are usually time-consuming processes that require additional information and additional paperwork. However, with persistence, you may be able to overturn your denial. You should speak to your primary physician and our office in order to determine the best course of action.
In summary, don’t be discouraged at the insurance process. It is often a long, time-consuming and sometimes frustrating process. However, if you are approved, the time spent to change your health and your life will be well worth it.
For those whose insurance policies will not cover bariatric surgery and who cannot self-pay, third party financing may be the best option. Third party financing may include an unsecured personal loan, credit card loans, a secured home equity loan, or specific medical financing. Some research on the Internet and by phone will uncover dozens of companies that provide such services. However, it must be noted that most, if not all of these financing options come with financing and interest costs, in addition to the cost of surgery. Please make sure that you are comfortable with the cost of the loan before you commit to it.
Credit cards can be useful because any purchase is generally pre-approved as long as it remains within the credit limit. These credit lines, however, may be lower than other traditional financing options. Credit cards also come with variable interest rates that may change over the life of the loan, so it is worth the time to fully understand the risk of using credit cards in order to finance your procedure.
A home equity loan and/or other collateralized loans also come with interest and finance charges. Please understand the consequences of default on these loans, which may include losing assets collateralized in the loan - this may include your home. In these types of financing, interest rates may be variable.
Finally, third party medical credit can vary widely in interest rates and terms depending on your individual creditworthiness. Please contact each financing company, as their repayment and cost terms will vary.
For those who are not suited to financing and cannot or do not wish to use insurance for their procedure, the option to self-pay is available. Self-pay patients are encouraged to contact our office in order to get a detailed overview of the costs of bariatric surgery at our facility, and to explore the repayment options that we offer. Because surgical team and surgical facility fall under the same umbrella, we are often able to roll all of the costs of surgery into one convenient package, ultimately benefiting you.