The first step is to talk to your health insurance plan representative. Coverage for weight loss surgery rose slightly in 2004, increasing from 23 percent of all employers to 27 percent, according to the National Survey of Employer-Sponsored Health Plans 2004 by Mercer Human Resource Consulting. Among large employers, 50 percent covered the surgery, up from 48 percent the year before. The survey also showed that large employers, who cover weight-loss surgery, are increasingly limiting eligibility to individuals who have complied with a behavior modification program.
In addition to speaking with your health care provider, surgeons who perform weight-loss surgery and their office staff can help patients explore their insurance and financing options.
Every plan is different. Yours may have a list of approved surgeons and hospitals in your area. If you want to use a surgeon who isn’t in the plan, ask about your options for out-of-plan services, and how that may affect costs.
If your plan refuses coverage, you may want to appeal the decision. Your plan representative will have all the details regarding what you need to do to make your case for funding.
If your health insurance is covered by Medicare, as with commercial plans, there are some restrictions on which facilities patients can use in addition to private or commercial health insurance policies. Still, people who are dependent on Medicare and are considering weight loss surgery are much better off than they used to be.
