Bariatrics: Payment Options
Paying for weight loss surgery should not be a barrier to reaching your weight loss goals. CareCredit, a GE Money Company, has a variety of payment plans for you. Depending upon your procedure, you can conveniently pay over time with a Low Monthly Payment Plan that fits comfortably into your lifestyle and budget. With low minimum monthly payment options, no up-front costs, no prepayment penalties and no annual fees, you can get your procedure sooner. To learn more, call CareCredit at 800-859-9975 or visit them online.
In most states, legislation requires insurance companies to provide benefits for weight loss surgery, including LAP-BAND® cost, when patients meet the National Institutes of Health (NIH) criteria. But even though insurance coverage is widespread, you should prepare for a lengthy approval process. There are a handful of companies that provide complete insurance coverage for LAP-BAND®. Please call the 800 number on the back of your insurance card and ask if the procedure is covered on your plan. Participating Insurances
Follow the steps below to increase your chances of being approved for coverage:
- Understand your insurance company's "certificate of coverage." You can request this from your employer or the insurance company directly.
- Get a referral from your primary care physician if necessary. Even if you don't need one, you must have your doctor's support to get coverage.
- Keep accurate, detailed records and save invoices and payment receipts.
- Document every visit to health care professionals for obesity-related issues, including weight loss programs, diet centers, fitness clubs, and people like a diabetes educator when applicable.
Insurance Authorization Process
After your initial consult with the Bariatric surgeon, your surgeon will write a letter to establish the "medical necessity" of weight loss surgery by proving:
- You are morbidly obese and have a BMI of 40 or higher (or a BMI of 35 or more; and experiencing obesity-related health conditions, such as high blood pressure or diabetes.)
- You have been obese for the past 5 years or longer.
- You have attempted other medically-supervised methods of weight loss for at least two years.
- You have co-morbidities such as hypertension, diabetes, sleep apnea, degenerative arthritis or heart disease that render surgery a medical necessity.
In March 2002 the IRS release information that the cost of weight loss programs that are part of the treatment of diseases, such as obesity, are tax deductible. The IRS stated, “Obesity is medically accepted to be a disease in its own right.” Those who participate in these programs for medically valid reasons will be able to deduct a percentage of their adjusted gross income. The ruling applies to current tax returns, as well as those dating back to 1998. For more information go to www.IRS.gov and search in forms and publications under “Obesity.” Consult your tax advisor for any deduction information regarding weight loss surgery, as tax laws continues to change and be updated.
LAP-BAND® is a registered trademark of Allergan, Inc.