Does Your Health Insurance Cover Bariatric Surgery?
Health insurance is 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 is a maze they’ll never understand, but we’d like to help you navigate those intricacies, especially now, during open enrollment, and as we come to the end of the year with benefits resetting.
Beyond the benefits page that explains what is covered and the costs you should expect to incur, it is important that you understand the exclusions of your policy as well. These are usually tucked away in the fine print. Most of us never even know what’s excluded from our policies. Beyond cosmetic procedures, most dental procedures, and most eye care, 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 important 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 a negotiated rate 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, you may wish to explore 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. At $10,995, including all pre-op, gastric sleeve surgery, facility fees and 6 months of post-op, your cost may be comparable to the deductible of your insurance policy.
What are Your Next Steps?
Considering bariatric surgery is a huge step and the beginning of a new and exciting future, attending our online seminar is a great step towards understanding more about the benefits and risks of surgery and getting to know our office. It also gives you some perspective and food for thought when you come to meet Dr. Tsuda or Dr. Ryan for your consultation. The next steps are crucial to ensuring that you maximize your payment options for surgery. We encourage you to contact your insurance company to understand your coverage options and requirements for surgery. We will confirm those benefits by performing our own insurance verification.
In the meantime, if you have any questions about insurance coverage or our cash payment plan, we encourage you to contact our office.