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 range of $20,000 to $23,000 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

(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.?

Helpful Tips When Speaking with Your Insurance Representative About Covering Weight Loss Surgery Cost

Do:

• speak slowly and clearly.
• ask for their name and write it down when they answer the call (request they spell it for you).
• ask for a specific phone number and/or e-mail address from the representative and write it down.
• ask that a hard copy of your policy be mailed to you with the areas regarding obesity and morbid obesity highlighted.
• make sure you receive it in writing if you are promised or guaranteed anything regarding weight loss surgery cost and your policy. This will provide you with documentation if you experience a claim dispute.
• keep a detailed record of all your documents.
• be persistent.

Don’t:

• be rude.
• demand anything.
• threaten anyone.
• get frustrated. If you experience an unpleasant representative, simply thank them for their time, hang up, and call back.

For more information on the weight loss surgery cost specific to your care, call the DeKalb Medical Surgical Weight Loss Center at 404.501.7081.