Lapband Surgery Mexico - Insurance for Lapband Surgery

Many people falsely assume they are covered for weight loss surgery by their insurance carriers. Often insurance companies offer Lapband surgery in only the most dire of circumstances. Patients are often surprised to learn that they have only received partial coverage, and make large payments to doctors, surgeons and the hospitals involved.

Did you know? The average person in the USA spends approx. $14,000.00 USD out of pocket for Lapband Surgery in the USA. Lapband Surgery in Mexico at a state of the art Medical Center averages just $9,000.00. (Due to our large group visits
Group Lapband Trip to Mexico can offer an all-inclusive rate of $7995.)

How do I know if I am covered for Lapband Surgery by my insurance carrier?

In order to determine if your insurance policy covers obseity, you will have to do a little research. When you first signup with an insurance company, they provide you with an information package. Typically there are two sections that describe any limitations. They are usually divided into "What is Covered by Insurance" and "What is not covered by Insurance". You will need to check for "bariatric" or surgical therapy for treatment of obesity.


I have Medicare / Medicaid, will they help me?

Sadly, many policies exclude bariatric surgeries. State Medicaid and Tricare programs for example, will flattly not pay for the LAP-BAND surgery in the USA or anywhere for that matter.

Medicare has indicated to the public they will help pay for LAP-BAND surgery, but only at a handful of medical centers. Any travel expenses, and the remaining portions and followup care must be paid out of pocket.

What insurance companies offer full or partial coverage?

The following insurance companies are known to offer at least partial coverage of your medical expenses for Lapband Surgery. This list is for informational purposes only and is subject to change at any time.

United Healthcare
Blue Cross (in some states)
Oxford Health Plan
Humana
First Health
American Family Insurance
One Health
Tufts Health Plan

My insurance company IS LISTED, what do I do now?

Call the Customer Service number on the back of your insurance card. When you speak to the customer service department, tell them you are checking on policy benefits. Ask them if surgery for morbid obesity is a covered benefit? Specifically you are caling to check for coverage of the Lap Band surgical procedure.

They may askf for a CPT code, if so use 43770. in the event they say yes, it's important to ask them exactly what their requirements are before authorizing surgery. Many insurance companies include exclusions that can be costly down the road for out of pocket expenses.

What are the insurance requirements for lapband surgery?

There are some requirements before most insurance companies will provide Lapband Surgery authorization.

Consultation with Dietician and Nutritionist before Lapband Surgery:

We know what a struggle it can be to fight obesity. We've been there ourselves personally. Unfortunatly the insurance companies would rather you do it yourself , even if it's something you've been battling all your life or is out of your control. They need convincing.

Because of that you will likely need the support of a liscensed dietician or nutritionist.


Do you meet the BMI requirements for Lapband Surgery?

Many insurance company policies will only cover the Lapband Sugery if your BMI is over 35 or 40. You'll need to visit your physician, all though the dietician can probably help you in assessing this.

Have you tried dieting in the past? What are your previous weight loss attempt results?

They will want to know if you you require a medically supervised diet. Often they will require a documented plan that is recorded by your doctor which includes diet and exercise. Rarely plans such as Jenny Craig or Weight watchers can be accepted.

Releasing your past records and ocumentation of weight history.

Most insurance companies will require a Five Year History. They want documentation to and a list of your doctors notes over the past five years, describing your weight loss struggles and patterns.

Three Months to One Year of Pre-Operative Planning

Many insurance companies will require you to take part in pre-op screening. These programs are designed to ensure your health for eventual surgery, but are also designed to ween out those who are just looking for a quick fix without diet.In these programs, you will be required to make monthly meetings with your Doctor, Psychologist and a Dietician for up to 12 months (1 year). After the period of time, the insurance company will act accordingly.

Despite all of this, most insurance companies will still only cover partial treatment leaving most patients with large out of pocket expenses.

Because of this, many people have turned to Mexican surgerons and their surgical centers for cost effective alternatives then utilize their insurance and doctors in the USA for follow-up and aftercare treatment.