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In an ongoing attempt to provide our patients with the best of care we offer this information as an aid in deciding about morbid obesity surgeries
If your health is in jeopardy how can you afford not to do something about it? Realizing that it may be difficult for many weight loss patients to be able to afford the Lap-Band or Roux-en-y gastric bypass surgeries we hope you'll find this page helpful.
The LAP-BAND® System is being covered by more insurance companies as they realize obesity is an overall health hazard and that surgical correction is many times a medical necessity. In that spirit we make every effort to work with your insurance company.
Plus the IRS states that now individuals can deduct medical and dental expenses if they total more than 7.5 percent of your adjusted gross income, as defined by IRS Publication 502. Medical expenses can include doctor's fees, payments for hospital services, prescription drug costs, physician co-pays and the cost of participating in a weight-loss aftercare program for obesity or any other medical condition. Be sure to check out this pamphlet for further info on tax benefits and please discuss with your accountant if this tax advantage would apply to you and if you would benefit from such a tax deduction.
To determine if your insurance policy covers weight loss or bariatric surgery, including roux-en-y gastric bypass surgery, refer to the insurance policy package that you hold either privately or through your employer. Specifically you can look for "Surgery for the treatment of obesity is covered when deemed medically necessary," or "Surgery for the treatment of obesity" is (specifically) excluded except when medically necessary. Or contact the Customer Service line and ask about the following CPT codes: 43847 (Roux-en-Y gastric bypass) and 43659 (adjustable gastric band), and if you can choose the surgeon you want to use. Be sure to keep record of the person you speak with.
If it is determined that if your insurance company does not cover the surgery, you may opt to pay for it yourself, or you may appeal to your insurance company, there is a lot more information about appealing to your insurance provider at Obesity Law
There are advantages to paying for it yourself, such as a possible earlier scheduling date for surgery, as your insurance company will take 4 - 6 weeks to review your case and you will not be waiting for this approval.
Medicare and Surgery for Obesity
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