Lap-Band surgery in Dallas, an alternative to gastric bypass surgery, is a procedure where an adjustable band is applied to the upper area of the stomach to reduce the amount of food intake. Can this removable, adjustable weight loss method be covered by your insurance plan? -It depends on the patient's insurance policy.
According to the Lap-Band system, over 80% of Lap-Band patients had some part or the entire procedure covered by their insurance company.
You can see what your insurance will cover by looking at the policy package you received after you purchased your plan or by contacting an insurance administrator. While some insurance companies cover the Lap-Band fully, others will only agree to cover the surgery if it is medically necessary. Your insurance company may also choose to only cover your pre- and post-surgery visits.
Some major Texas insurance providers that offer partial or full coverage are:
- United Healthcare
- Aetna
- Cigna
- Tricare
- Blue Cross/Blue Shield
Full Coverage Guidelines
For medical necessities, your insurance provider may require that you provide them with a "Letter of Medical Necessity" from your surgeon before the full coverage of the procedure can be authorized. This letter should include your weight, your BMI (body mass index), how long you've been overweight and what other methods, medications and alternatives the patient has tried as well as the medical complications that have been caused by the patient's weight. The letter should be as detailed as possible. Any setbacks due to your weight should be included, especially if they include basic activities such as getting out of bed, walking, etc. If any weight loss or exercise programs have been tried, receipts or proof of membership should be attached as well. Also, include the amount of doctor visits that have been made related to a weight issue.
The more detailed the letter is, the better. The patient should include any personal setbacks because of their weight, such as trouble with basic, everyday activities (getting out of bed, walking, running, sitting down and more.) If the patient has tried any weight loss programs in the past or tried exercise classes, they should attach receipts or proof of membership. It is also imperative to list how many times the patient has visited a doctor for weight-related issues. The doctor can also help by including any brochures or studies from health professionals about the success rate of the surgery or ways it can benefit his patient's life.
Make sure to keep copies of all documents you send your insurance company in case they need you to resend anything or there is a dispute about what they have received.
Am I eligible for financial aid?
In 2006, there was a National Coverage Determination published for bariatric and Lap-Band procedures by the Centers for Medicare and Medicaid Services, which states that the procedure could be covered through those policies. You should call your provider to check your coverage availability.
What if my insurance doesn't cover my procedure?
There are other options available. Most clinics offer payment plans for those who must pay out of pocket. Loans are also available.
According to the Lap-Band system, over 80% of Lap-Band patients had some part or the entire procedure covered by their insurance company.
You can see what your insurance will cover by looking at the policy package you received after you purchased your plan or by contacting an insurance administrator. While some insurance companies cover the Lap-Band fully, others will only agree to cover the surgery if it is medically necessary. Your insurance company may also choose to only cover your pre- and post-surgery visits.
Some major Texas insurance providers that offer partial or full coverage are:
- United Healthcare
- Aetna
- Cigna
- Tricare
- Blue Cross/Blue Shield
Full Coverage Guidelines
For medical necessities, your insurance provider may require that you provide them with a "Letter of Medical Necessity" from your surgeon before the full coverage of the procedure can be authorized. This letter should include your weight, your BMI (body mass index), how long you've been overweight and what other methods, medications and alternatives the patient has tried as well as the medical complications that have been caused by the patient's weight. The letter should be as detailed as possible. Any setbacks due to your weight should be included, especially if they include basic activities such as getting out of bed, walking, etc. If any weight loss or exercise programs have been tried, receipts or proof of membership should be attached as well. Also, include the amount of doctor visits that have been made related to a weight issue.
The more detailed the letter is, the better. The patient should include any personal setbacks because of their weight, such as trouble with basic, everyday activities (getting out of bed, walking, running, sitting down and more.) If the patient has tried any weight loss programs in the past or tried exercise classes, they should attach receipts or proof of membership. It is also imperative to list how many times the patient has visited a doctor for weight-related issues. The doctor can also help by including any brochures or studies from health professionals about the success rate of the surgery or ways it can benefit his patient's life.
Make sure to keep copies of all documents you send your insurance company in case they need you to resend anything or there is a dispute about what they have received.
Am I eligible for financial aid?
In 2006, there was a National Coverage Determination published for bariatric and Lap-Band procedures by the Centers for Medicare and Medicaid Services, which states that the procedure could be covered through those policies. You should call your provider to check your coverage availability.
What if my insurance doesn't cover my procedure?
There are other options available. Most clinics offer payment plans for those who must pay out of pocket. Loans are also available.
About the Author:
Band Lap Texas weight loss procedures provide some of the best ways to help control obesity. However, you will need to meet certain qualifications before you are allowed to undergo Band Lap Texas surgery. To find out more about Lapband surgery and other surgical procedures for weight loss, talk to your doctor.
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