Weight loss surgery has become very popular in recent years. More people are becoming interested in the procedure to help them shed unwanted pounds. If you are considering undergoing weight loss surgery, it is important that you find the right insurance company for your operation. While many insurance companies have not changed much in their guidelines regarding surgeries, there are a few that have slightly loosened their restrictions. Knowing these insurance company secrets can make it easier to get the surgery you need and you at the same time don't burn a hole in your wallet. Here are some of the weight loss surgery insurance secrets that most insurance companies won't tell you about.
One of the biggest weight loss surgery insurance secrets is that some insurance companies do not cover the cost of the surgery. While it is usually considered cosmetic, many people will still have to pay for it out of pocket. If you have a pre-existing medical condition, your surgery may be covered by your insurance company, but it will not be covered unless you can prove that your condition is life-threatening or chronic. There are a few insurance companies that specifically exclude the surgery coverage, so it is important to call and ask about it. If you cannot make a case for exclusion, you should contact your physician and see if he can review your medical records with your doctor to determine if the coverage is excluded.
Another one of the weight loss surgery insurance secrets is that they want to see physical activity for a minimum of 12 months prior to your surgery. The reasoning behind this is that you will be recuperating from your surgery and may not be able to get back into shape as quickly as you would like to. Therefore, the physician will request that you get a minimum of six months of near-by activity per year. The insurance company will then cover about half of the total cost of your procedure, which means that you will pay less than two-thirds of the bill. Be sure to keep your physician's details handy so you can ask any questions you may have.
Another of the weight loss surgery insurance secrets is that you will need to lose at least seventy pounds by the time you leave the hospital. Your doctor will fill out a medical release form that states that you have successfully completed the program and that your doctor has approved the procedure. However, when you go to obtain Medicare coverage, your doctor will provide you with a letter stating that you need to lose more than seventy pounds. To obtain the Medicare policy, you must meet all of the eligibility requirements regardless of whether you have lost weight or not.
According to many people who have gone under the knife, MRT (Medicare Part B) was the deciding factor in their surgery. The reasoning behind this is that most insurance companies require a certain BMI before considering you an eligible patient. Since obesity is associated with a host of medical problems including high blood pressure, diabetes, and heart problems, MRT is one of the easiest ways to avoid spending money on prescription drugs. Unfortunately, many of the plans offered by the private companies do not cover surgery due to the fact that such a large amount of change in your body will have a significant impact on their ability to process your claims.
If you are going to get gastric bypass surgery or you are seriously considering having it, you should know that it is likely that you will need to pay for both the procedure and for hospitalization and doctor visits. Your insurance may cover up to seventy-five percent of the bill, but they may require you to pay for both at the same time. In order to obtain a quote for gastric bypass surgery, you will need to call several different companies in order to get an accurate comparison.
Another of the weight loss surgery insurance secrets is that you should consider getting a consultation with the surgeon prior to having the procedure. A consultation session can help you become more comfortable with the surgeon as well as with the entire process of having the surgery. You will need to be honest with the insurance company about your mental health history, but the actual physical exam will be part of the process.
The most important thing to do is to compare quotes from several different companies before making your decision. You will also want to inquire about surgeon added coverage. Often, certain surgeries will not be covered unless the insurance companies have surgeon added to their plan. This can be a great way to avoid unnecessary surgery or illness.
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