Insurance coverage for bariatric surgery varies according to the insurance carrier, and those that have specific coverage in their plans for bariatric surgery. Insurance companies that cover weight loss surgery have varying requirements. Some may require medical records documenting co-morbidities (medical problems caused by your obesity) and/or records of medically supervised weight-loss programs. Many companies require a supervised weight-loss program within two years of your proposed surgery date.Our office participates with most insurance plans. Our Pre-Authorization Department will work with you and your insurance carrier to obtain authorization for your surgery.
- Psychological Evaluation
- Nutritional Evaluation
- Gallbladder Ultrasound
- Letter of Medical Necessity from your Physician (upon request)
- 2-5 year weight history (criteria varies by insurance carrier)
- 3-6 month supervised weight-loss program (criteria varies by insurance carrier)
***Additional testing/documentation may be requested by your insurance plan or your surgeon***
Pre- Determination Forms
If you already have a provider or the providers listed below are out of network please contact your insurance company for more options.
- Laura Rojas, LMHC – Psy Eval Gayle Brazzi, RD, – Nutrition Eval – 321-843-8900
- Cardiologist- Adam J. Waldman, M.D.– 407-380-6020
- Cardiologist- Marcos Hazday, MD – 407-841-7151
- Labs, Gallbladder, Upper Gi, EKG- Orlando – 321-841-5274
Frequently Asked Insurance Questions
- How do I know if my insurance covers bariatric surgery? Contact insurance customer service and ask them if you have coverage for 43644- gastric bypass, 43775- sleeve gastrectomy.
- Bariatric surgery is excluded from my plan what can I do? If you have plan a exclusion please review our self pay option www.medloanfinance.com.
- Can I use my own providers for my testing? Yes, you can use your providers for your testing with the exception of the nutritionist. It is necessary that you meet Gayle our program dietician to discuss our program guidelines.
- I have completed all of my documentation, what is the next step? Once you have completed all documentation required by your insurance, our pre-authorization department will submit your case for insurance approval.
- How long does it take for my insurance to approve me for surgery? It may take approximately 2-4 weeks from initial submission.