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Financial considerations for weight loss surgery
Following the process of researching bariatric weight loss surgery and determining whether or not it is an option an individual may
wish to consider, financial matters must be investigated. A growing number of states have passed legislation that requires insurance
companies to provide benefits for weight loss surgery patients who meet the National Institute of Health’s surgical criteria. While
insurance coverage of weight loss surgery is a rapidly growing resource, it often results in a time consuming and complicated approval
process. Working with a bariatric surgeon and other health experts often guarantees the best opportunity for success.
A Few Guidelines When Considering Financial Matters
• Read and understand the “certificate of coverage” that an insurance company is required to provide to its clients.
• Follow the health process outlined by the insurance company. Begin by visiting with a primary care physician.
Often the physician is the only individual who can offer a referral to a qualified bariatric surgeon.
• Organize medical records, including a detailed record of all past dieting attempts.
These are invaluable resources at all stages of an insurance approval process.
• Document every visit made to a health-care professional in regard to obesity-related issues, or visits to
supervised weight loss programs. Document other weight loss attempts made through diet centers and
fitness club memberships. Keep good records, including receipts.
• If the bariatric surgeon recommends weight loss surgery, he or she will prepare a letter to obtain pre-authorization from the
insurance company. This will establish the “medical necessity” of the procedure and gain approval.
The following information is generally included:
— Height, weight, and body mass index, as well as any documentation of how long obesity has been a medical problem.
— Full description of all obesity-related health conditions, including records of treatment, a history of medications, and
documentation of how these health conditions have affected everyday life, such as limitations placed on all types of
activities from walking and other physical mobility, to tying shoes and personal hygiene.
—A detailed history regarding the results of dieting efforts, including medically and non-medically supervised programs,
medical records, and records kept of payments to, and meetings attended with, commercial weight loss programs.
— A history of exercise programs, including receipts for memberships in health clubs.
Even if insurance coverage is denied, appeal can be made. Or, if insurance is not available, MIMIS offers payment plan options,
working to make weight loss procedures possible for everyone who meets the program qualifications. For further questions regarding
program requirements, financial considerations, or other weight loss surgery information, contact the Bariatric Program,
1-888-546-4343 or 1-218-54-MIMIS. |
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MIMIS and Dr. Howard McCollister are approved as a Bariatric Surgery Center of Excellence by the American Society for Bariatric and Metabolic Surgery and the Surgical Review Board. The Centers of Excellence designation is a result of a rigorous review and evaluation process. It is a tribute to MIMIS’s efforts to foster and maintain the highest standards and quality of care for every patient in our weight loss program. 
