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Insurance Policy Information

For Gastric Bypass Surgery

Gastric Bypass and Sleeve Gastrectomy surgery usually require a 2-3 day hospital stay and 2-6 weeks recovery time depending upon the type of work you do. Gastric Banding requires 1 day hospitalization and 1-2 weeks recovery period.

Bariatric surgery is a covered benefit by many insurance companies, depending upon the type of policy you have and its terms. Insurance policies vary although they may have been issued by the same insurance company.

Some patients may choose to pay for the surgery on a self- pay basis. These arrangements can be made by calling the Bariatric Center and speaking directly with the insurance co-ordinator. There are 2 fees to consider, one for the surgeon and another for your hospital stay.


Medical Necessity

Insurance coverage depends upon the determination by your primary care physician, surgeon and sometimes a specialist, that bariatric surgery is medically necessary to reduce significant medical risks to your life.

A thorough medical history, a detailed diet history over the past two consecutive years under medical supervision, current height, weight and BMI (body mass index), and a list of all co-morbidities that are or may be caused by your morbid obesity must be included in a letter of medical necessity written by your primary care physician and provided to the Bariatric Center for submission to your insurance company. This letter, along with a psychological evaluation/clearance is a requirement for all insurance companies.


Insurance Denials

If you receive a denial of coverage by your insurance company, you should not consider this to be a "definite no". In many cases, providing additional detailed information, in the form of an appeal letter, will result in a denial being overturned. If your insurance carrier remains unreasonable, you may want to consider writing to your legislator or seeking legal assistance. Insurance companies will often relent as they try to avoid confrontation.

Insurances taken by our doctors.