Insurance Verification

Please contact your insurance coverage to see if your specific health plan covers Bariatric services and surgery especially if you have commercial insurance.

If you do not contact your insurance to know the requirements, you may have to pay out of pocket for visits.

Information to gather from your insurance:

  1. Does your plan cover bariatric services and surgery or is it an exclusion or only covered if life-threatening (meaning they do not cover bariatric surgery)?
    • Here are the specific codes that your insurance company may request.
      • ICD code of obesity E66.01
      • CPT code for sleeve 43775
      • CPT code for bypass 43644
  2. If your plan covers Bariatric services and surgery, you will need to know what pre-surgical requirement are necessary to qualify for surgery.
    • Example: Medicaid requires 6 consecutive months of medical weight management and psychological evaluation.
  3. What is your portion of the cost will be?
  4. In case you need to contact them again, it is important to write down who you talked to as well as a reference number for the call.