Health insurance is a tricky business, and if you feel like it’s been going up in cost and down in benefits every year, you’re right. For many, health insurance can be a complex maze they’ll never fully understand, but we’d like to help you navigate those intricacies.
Beyond the benefits page, which explains what is covered and the costs you should expect to incur, it is also essential to understand the exclusions of your policy. These are typically found in the fine print. Most of us are unaware of what’s excluded from our policies. Beyond cosmetic procedures, most dental procedures, and many eye care treatments, bariatric surgery is often excluded as well. So, as you consider your eligibility for bariatric surgery, give your insurance company a quick call to check your benefits, or contact us – our office will be more than happy to assist with verifying and confirming your benefits.
Other Things You Should Understand
An essential aspect of your health insurance plan is its network. These are the doctors, facilities, and other clinical practitioners that are considered in-network. In-network providers have negotiated rates with your health insurance carrier, and your costs are usually lower as well. However, if your provider is not in-network with your insurance company, don’t worry. Contact the billing office to understand what costs you would be responsible for.
You should also be aware of your deductible (the amount you are responsible for before insurance kicks in), your co-pay (the fixed amount you need to pay for each visit or service, which can vary between specialties and services), your co-insurance (the percentage of the cost of service that you will be responsible for once your deductible is met and copay paid), and total out of pocket expense.
You should also be aware that insurance benefits reset at the end of each calendar year. That means that you will be responsible for the entire deductible and out-of-pocket expense come January 1, no matter how much of your policy was used in the prior year.
What If My Insurance Doesn’t Cover Bariatric Surgery?
If your insurance policy does not cover bariatric surgery, consider exploring cash or self-pay pricing. VIPSurg is proud to have one of the lowest, all-inclusive cash pay packages in the Las Vegas region for those considering bariatric surgery. VIPSurg offers an excellent cash pay rate starting at $9,750 for patients interested in the gastric sleeve procedure, which includes all pre-operative consultations and visits, pre-operative EKG, gastric sleeve surgery, facility fees, and 6 months of post-operative care. Your cost may be comparable to the deductible of your insurance policy.
