Lap-Band Surgery Insurance Considerations

Lap Band surgery can be costly, but in many cases this procedure may be covered by some insurance companies and plans. Some plans and companies will cover the entire cost of this surgery if you meet certain criteria, while others may only cover part of the costs involved, and some plans do not cover any of these expenses. Lap Band is a procedure known as bariatric surgery, and the goal is weight loss. If these procedures are covered at all it will be included in the insurance policy information that you received when you first purchased the health insurance. Your policy is a manual outlining what your insurance will and will not cover, and this material will help you determine whether or not your policy covers bariatric procedures.

Many of the health insurance companies and plans which do cover part or all of the costs of Lap Band surgery will only do so if it is determined that this procedure is medically necessary. If you meet the national guidelines for being morbidly obese then this surgery is generally considered medically necessary, because without this intervention the obesity will lead to medical problems and premature death. If you are covered by a plan that does pay for this type of bariatric surgery you may find that only part of the total expense is actually covered by your health insurance. The insurance company may only pay a certain percentage, or only cover some of the specific costs involved.

If you have coverage that will pay for part or all of your Lap Band surgery costs there are still some steps that you must take so that your plan actually pays the bill. Almost every insurance company that will pay for this type of expense requires prior authorization before this surgery can be performed. You may also be required to turn in a Letter of Medical Necessity which is completed by your physician, showing why this surgery is medically necessary and should be covered.

The first thing you should do to see if your health insurance will cover any of the cost fro your Lap Band surgery is to examine your policy closely. There is a section which should list all of the expenses that the plan will cover, and also a section which lists those expenses and treatments that the plan will not pay for. Look for any listing that discusses obesity treatments, weight control, or bariatric procedures. If your plan will not pay for this type of surgery then other payment arrangements may be possible. Some centers will allow payment arrangements, while others may provide information about medical loans.