Posted by Michelle Johnson

• Number of years you have been overweight - In nearly all cases, insurance providers and weight-loss surgeons will look for patients that have been overweight for at least five years.

• Body weight or body mass index (BMI) - Candidates for weight-loss surgery should be at least 100 pounds over ideal body weight, or have a BMI of at least 40. In some cases, patients with a BMI of 35 who have at least one health condition related to obesity can be candidates for weight-loss surgery.

• Obesity-related medical problems - It is important to document the presence of conditions such as type 2 diabetes, sleep apnea or hypertension as secondary medical concerns. This can help your insurance provider recognize the importance of your weight-loss surgery procedure.

• Failed weight-loss efforts - It is important that you provide as much information as possible about all failed weight loss attempts. This documentation should include an outline of your diet and exercise efforts as demonstration of your longstanding commitment to weight loss, regardless of the results. Whether the information provided comes from your own records, a commercial weight loss program or previous medical supervision, the more documentation you provide attesting to your efforts to lose weight , the greater chance you have of receiving approval from your insurance provider.

In addition to the information outlined above, you may also need to receive psychological, nutritional and/or other similar evaluations. When communicating with your insurance provider, you should also try to be very specific in describing your condition. As obesity and morbid obesity are classified as two distinct medical conditions, you want to make sure that your insurance provider understands your correct obesity classification when evaluating your claim.

How NewHope Bariatrics Can Help

As the requirements for insurance coverage can often be difficult to understand, NewHope Bariatrics is committed to help patients navigate the process. Having worked directly with numerous insurance providers, NewHope Bariatrics can assist patients in completing the necessary paperwork and assisting with the insurance authorization process. NewHope Bariatrics can also help patients determine the amount of available coverage, highlight any possible contractual agreements between NewHope Bariatrics and the insurance provider and help estimate any out-of-pocket costs. NewHope Bariatrics and our physicians will provide support in working with you and your insurance company throughout the authorization process.

If you don’t have insurance or your plan doesn’t cover the LAP-BAND® System, NewHope Bariatrics can also work with you to find an affordable financing program. There are several payment packages and discount opportunities available and prospective patients can take advantage of free referrals to a number of trusted lenders who are familiar with helping weight-loss surgery patients.

Whether your insurance covers the LAP-BAND® procedure or not, you will also have an opportunity to see a unique cost comparison during your financial consultation. Most people don’t think they can afford to pay for LAP-BAND® surgery, but what many people don’t realize is that they can hardly afford not to. The costs of living with obesity can exceed $15,000 annually! The LAP-BAND® procedure can practically pay for itself within one year. Additionally, patients without adequate insurance coverage can also take advantage of potential tax deductions, bringing the total cost down even further.

As the LAP-BAND® is regarded as both the most affordable and lowest risk weight-loss surgery, the benefits of the procedure far outweigh the costs for most patients. Though your chances of receiving insurance approval will be contingent on the requirements of your provider, there are many funding options available to prospective patients. As obesity takes such a great toll on life - both physically and financially - the LAP-BAND® procedure can represent an incredible opportunity for all qualified individuals.

Carole S. Guinane, a Chief Clinical Officer writes articles about obesity and weight loss for New Hope Today

By Carole S. Guinane

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