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 like in order to approve the surgery. To see if your insurance covers the procedure and what they require please schedule your initial consultation and we will do an insurance assessment. Lap Band Solutions will give you all the information of the requirements, coverage, and out of pocket expense that is needed by your insurance about 7-10 days after your initial consultation. If you haven't made your appointment call today for you initial consultation.
*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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Insurance Verification
To determine if your insurance policy covers obesity (or "bariatric") surgery, 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.