The other types of bariatric surgery are less likely to be covered, although you may be able to get insurance to pay for some of the costs. Contact your insurance provider to determine if obesity is covered. Weight loss surgery (also known as bariatric surgery) is not universally covered by insurance companies. If you’re a Duke employee, visit the Duke Human Resources to learn about eligibility requirements. However, 23 states currently require some sort of coverage for bariatric surgery as part of their essential health benefits package. Diabetes 2.2. Weight loss surgery "Included" Heart and vascular system ... transport accident or other types of insurance pay for some reason. Our financial care counselors can give you estimates of what procedures will cost. Bariatric Surgery Health Benefits Tool (Gastric Sleeve). This typically takes place at your first weight loss appointment. If you have been complaining of a bad back, bad ankles or other weight related problems and have tried everything else they may pay for it. Please note that payment is required in full before the procedure can be performed. Medicare covers weight loss surgery if you meet certain criteria, such as having a BMI greater than 35. Nuffield Health Hospital's are also experienced in helping those patients with very high BMI’s (over 40) as our specialist centres are able to provide extra medical support to address your safety and individual needs. So it’s not surprising that many are turning to surgery as an answer - in 2007-08 around 17,000 Australians had weight loss surgery (also known as bariatric or obesity procedures). Which procedure you choose – if insurance won’t pay, costs range anywhere from $8,000 to $20,000+, depending on the procedure. © Copyright 2020 Bariatric Surgery Source, LLC — All rights reserved, [get_data_from_ci_map_list url="maplist/maplistNewdesign"], Life After a Weight Loss Procedure (Start Here), CEO & Editor-in-Chief of Bariatric Surgery Source, Complete List of Insurance Companies & Bariatric Policies, HMSA (Hawaii Medical Service Association), QualChoice – Federal Employees Health Benefits, Financing Weight Loss Surgery to Make It Affordable, Medical Travel – Save by Traveling for Weight Loss Surgery, Back To Bariatric Surgery Insurance Guide from Insurance That Covers Bariatric Surgery, Back To Bariatric Surgery Source Home Page, You can ask a local bariatric practice for a free insurance check or cost quote, You can attend a free in-person seminar or an online webinar offered by a local weight loss surgeon, You should schedule a phone or in-person consultation (both often free), if you are interested in learning more about weight loss surgery, Have a history of failed weight loss attempts (e.g., failed diets), Thoroughly understand that the procedure is just a tool; long-term success requires significant diet and lifestyle changes, OR a BMI between 30 and 39.9 with a serious obesity-related health problem like diabetes, high blood pressure, sleep apnea, high cholesterol, joint problems, or others, OR a BMI of 30 to 40 with or without health issues for the gastric balloon procedure, How closely you follow your doctor’s instructions, Archer Medical Savings Account (Archer MSA), Hospital Stay: from outpatient (return home same-day) to 3 days, Your current age, weight, health issues, habits, and lifestyle, What “trade-offs” you are willing to make. You will start losing weight fast after any bariatric surgery procedure, but the total amount lost varies based on: Enter your information into the tool to get an idea about how much weight you’ll lose after each procedure. Bariatric surgery insurance coverage varies by insurance policy: Individual/Family Plans & Small Group Plans – Coverage varies by state; coverage is required by the Affordable Care Act in some states, Large Group Plans – Coverage depends on whether your employer has chosen to add it to your policy, Medicare and Medicaid – Bariatric surgery is covered. Click here to contact a local surgeon to ask for your free insurance check. You’ll also need to save your medical bills and payment statements as proof. To receive the deductions, you’ll need to complete Schedule A of the IRS Form 1040. Bariatric Surgery Tax Write-Off Calculator. Whats the best insurance to get that will cover weight loss surgery? To receive the deductions, you’ll need to complete Schedule A of the IRS Form 1040. Insurance providers may have different requirements for their coverage of weight loss surgery. This site complies with the HONcode standard for trustworthy health information: verify here. If morbid obesity or obesity is a covered benefit, check that the procedure you are considering is also covered by giving your insurance provider the following codes: Ask if Duke Regional Hospital, Duke Raleigh Hospital, Regional Anesthesia, Duke Department of Psychiatry, and the physicians of the Private Diagnostic Clinic at Duke University Hospital are accepted by your insurance. If your policy covers weight loss surgery, most plans will pay for you to have gastric sleeve, gastric bypass, Lap-Band, or duodenal switch surgery. A few major insurances accepted at TBS are, but not limited to are: If you’re considering weight loss surgery, also known as bariatric surgery, determining whether your insurance plan will cover your procedure is an important first step. Hospital treatment for surgery that is designed to reduce a person’s weight, remove excess skin due to weight loss and reversal of a bariatric procedure. If you are over 18 and have a Body Mass Index (BMI) of over 35, weight loss surgery could help you lose weight. We are happy to say that there is insurance for Bariatric Surgery that covers more than 80% of our bariatric surgeries and Texas Bariatric Specialists (TBS) accepts all major insurance plans, including Medicare! Participate in a medically supervised weight loss program. Bariatric surgery “cures” or significantly improves many obesity-related health conditions, including: Select your health conditions in the tool, then click the Submit button to find out the impact a procedure like gastric sleeve can have. You can deduct medical expenses if the costs are more than 10% of your adjusted gross income. Any questions regarding specific plan benefits and payments should be directed to your insurance company. Give your provider the ICD10 code E66.01 (morbid obesity, BMI over 40) or code E66.0 (obesity, BMI unspecified). See our Insurance Tool to find out if your plan covers it. You need to meet requirements and deemed severely obese. Please Contact us at 310-825-7163. Whether you qualify for tax write-offs – Bariatric surgery is tax deductible, which can have a big impact on the total cost of surgery. Duke Health employees have no authority to make changes to individual plans. Money in one of the following special savings accounts (or even your IRA) may also be a way to pay for part of surgery tax-free: Use the tool to find out if you qualify for a tax deduction. Some studies show that people who have weight-loss surgery are less likely to die from heart problems, diabetes, or cancer compared to obese people who did not have the surgery. Insurance coverage for gastric sleeve tends to be similar in scope to coverage of other bariatric surgeries Almost all insurance companies in the U.S. (see full list below) have policies that cover bariatric surgery. Medicare covers weight loss surgery; Medicaid covers weight loss surgery (but not all surgeons accept Medicaid) If your insurance policy covers weight loss surgery, insurance will only pay for it if: You have a qualifying body mass index (BMI) of 35+ with obesity-related health problems or a BMI of 40+ (with no accompanying health problems necessary)