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Costs

There are many costs associated with weight loss surgery, also known as bariatric surgery. Before you can even be cleared for surgery, you will incur costs for pre-operative visits and testing. A variety of clearances and approvals are required for you to have the surgery, so you will want to attend DeKalb Medical’s free informational seminar to find out how to get started, potential weight loss surgery costs and what to expect.

No Insurance and/or Bariatric Benefits

Weight loss surgery cost varies for the surgical procedures at DeKalb Medical and will depend primarily on your needs and the surgery you pursue. A cost starting at $16,000 is probably realistic. Medicare and some insurance providers may cover a portion of the weight loss surgery cost. If you do not have bariatric insurance coverage, it is still possible to have one of these procedures done on a self-pay basis. With the self-pay option, you won’t be delayed by having to wait for insurance approval. DeKalb Medical offers competitive self-pay package rates.

Weight Loss Surgery Cost and Insurance

It is important to check with your insurance company prior to starting this process to see if they will cover weight loss surgery cost. You may contact them by calling the toll free number listed on your card for customer service. Many insurance companies have their coverage and benefit information on their Web site.

Here are a few helpful questions to ask your insurance company about covering weight loss surgery cost:

1. Is the bariatric procedure code a covered benefit?

Laparoscopic Roux-en-Y Gastric Bypass Surgery - Code 43644

Laparoscopic Gastric Banding Surgery - Code 43770

Laparoscopic Sleeve Gastrectomy - Code 43775

Loop DS- Code 43845

(Be sure to clarify that you are asking about the procedures on the basis of medical necessity.)

2. What limits and/or requirements are stated in order to receive morbid obesity treatment? For example:

  • Is there a certain amount of required time you must document attempted weight loss?
  • Does the documented time have to be consecutive?
  • Is your physician required to document your weight-loss attempts?
  • Do you need to weigh a certain amount before treatment is initiated and/or performed?
  • Is there an age requirement to receive care?
  • Must you use a specific Center of Excellence or medical provider to receive coverage?
  • Are there weight limitations preventing coverage?

3. Are my surgeon and DeKalb Medical providers under my plan?

4. What testing is covered, such as nutritionist, psychologist, labs, sleep apnea study, ultrasounds, etc.?

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