Many health insurance plans, Medicare and most Medicaid plans cover bariatric and metabolic surgery, but every insurance plan is different. So, it is important that patient’s review their benefits brochure carefully or call and speak directly with their insurance agent. Speaking with an agent can help patients find out if bariatric and metabolic surgery is covered and, if it is, which particular procedures are covered, what pre-approvals are required, which surgeons are in their network and if pre-approvals are required An insurance agent can also help to identify what the co-pays and deductibles are.
Another great resource for patients is to contact their bariatric surgeon’s office. If they have already identified a surgeon, they can contact that surgeon’s office to determine if there is someone in the office that can help them work through the insurance process. Many surgeons have a bariatric coordinator, or other person in their office, that is knowledgeable about the insurance requirements and process and can make the whole journey much easier.
The important point is that patients often hesitate to consider surgery because they fear that it will be prohibitively expensive. Many find that it is more affordable than they think. Encouraging patients to get the facts early will greatly assist patients to be comfortable in considering all of their treatment options.