Insurance Pays for LAP-BAND® Surgery

For example, United Healthcare, Aetna, Cigna, Blue Cross Blue Shield, Humana, PHCS and many others.

 

Most major insurance companies cover the Lap-Band® procedure*. Normally insurance requires a minimum body mass index of at least 35 or greater and may require some general criteria in order to approve the surgery. Lap Band Solutions will conduct a free nsurance assessment to find out your benefits and requirements to have the LAP-BAND surgery. Lap Band Solutions will give you all the information of the requirements, coverage, and out of pocket expense that is needed by your insurance at the time of your initial consultation. If you haven't made your appointment call today at by calling 214.556.3663 if you are in the the DFW or 713.464.2263 if you are in the Houston area.

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Understand the Insurance Process and Exclusions

*Although most insurance pays or covers the lap band procedure, your employer may have excluded Morbid Obesity from your plan. We will find out about your coverage after your initial consultation but if you would like to check on your own please contact your insurance customer service/benefits department and ask if there are any exclusions present for Morbid Obesity. If none are present and you meet the criteria then they may cover the band. If insurance does not cover the procedure do not be discouraged more than half of our patients finance the surgery.

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To determine if your insurance policy covers obesity (or "bariatric") surgery yourself, refer to the insurance policy package that you have received after paying your first premium or provided through a plan offered by your employer. Typically, there are two sections that describe the extent and limits of coverage. The first is usually called "What Is Covered" or "Covered Expenses." These are the healthcare benefits for which the company will pay. The other section is "What Is Not Covered" or "When the Plan Does Not Pay Benefits." In this section, look for any statement that the company excludes coverage for weight control, for the treatment of obesity, for the surgery for weight control, or for the complications of the surgery for weight control. Some policies will outright exclude bariatric surgeries. Others may have certain parameters around which bariatric procedures they cover and how much of the costs they cover. Look for statements such as, "Surgery for the treatment of obesity is covered when deemed medically necessary," or "Surgery for the treatment of obesity is (specifically) excluded except when medically necessary."

Please note: The CODE for LAP-BAND® for insurance purposes is CPT 43770, diagnosis code 278.01: morbid obesity.