Welcome to
Baltimore Bariatrics 
Paying For Your Weight Loss Surgery:
A Discussion of Your Insurance Options
A growing number of states have passed legislation that requires insurance companies to provide benefits for weight loss surgery for patients that meet the National Institutes of Health surgical criteria. And while insurance coverage for weight loss surgery is widespread, it often requires a lengthy and complicated approval process.
The best chance for obtaining approval for insurance coverage comes from working together with your surgeon and other experts.
Here are some of the key steps you should take to obtain insurance coverage for weight loss surgery:
- Read and understand the "certificate of coverage"
that your insurance company is required by law to give you. If you do
not have one, consult your company's benefits administrator or ask your
insurance company directly.
- You may be required to start with your primary care
physician. In some cases, he or she is the only one you can ask for a
referral to a qualified bariatric surgeon. Even if you are not required
to get a referral, it is a good idea to have the support of your
primary care physician.
- Before visiting the bariatric surgeon, organize your
medical records, including your history of dieting efforts. They will
be valuable documents to have at every stage of the approval process.
- Document every visit you make to a healthcare
professional for 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 your surgeon recommends weight loss surgery, he or
she will prepare a letter to obtain pre-authorization from your
insurance company. The goal of this letter is to establish the "medical
necessity" of weight loss surgery and gain approval for the procedure.
Additional Considerations: