Insurance Coverage Requirements
The Florida Surgical Weight Loss Centers accepts most health insurance plans. Many insurance companies have strict criteria for assessing bariatric surgery coverage.
Since the verification of benefits can be quite complicated and time consuming, we will verify your insurance coverage, your specific policy’s criteria for coverage for at no cost and with no obligations. If you would like us to verify your insurance policy details, please contact us so that we can collect the necessary information from you.
We do not have a “program” or “administrative” fee like other programs. Your financial responsibility will solely be your insurance copays and/or deductibles and the price of your liquid diet prior to your surgery, which will be between $100 and $300, depending on the length of time you will need to be on the liquid diet.
General Requirements for Insurance Coverage
Many insurance plans require the following documentation in order to determine if you are a candidate for surgical weight loss surgery:
- BMI Requirement: For insurance patients, you must have a BMI of 40 or greater, or have a BMI of 35 or greater with a qualifying comorbidity (a condition caused or worsened by your excess weight) such as high blood pressure, diabetes, high cholesterol, sleep apnea, etc..
- Surgical Consultation: This visit will consist of a physical examination and discussion with one of our surgeons. Your surgeon will determine your candidacy for surgery and you will discuss which surgical weight loss options are best for you. Your cost at this appointment will be your specialist office visit copay.
- Medically-supervised Weight Loss Documentation: Some insurance providers require that you have documentation stating that you have completed a medically-supervised weight loss program, which can also be accomplished with Florida Surgical Weight Loss Centers. To satisfy the insurance companies, you will usually need to see your surgeon once per month for 3-6 consecutive months. Your cost at these appointments is still just your specialist office visit copay.
- Psychological Evaluation: a psychological evaluation is an integral part of your weight loss journey, and is a prerequisite to weight loss surgery. Please contact us for a list of approved psychologists that are able to file claims with your insurance carrier.
- Nutritional Evaluation: A nutritional evaluation is required by most insurance companies and will help familiarize you with your post-operative diet. We provide this evaluation at no cost to you.
At the Florida Surgical Weight Loss Centers, we are happy to help you determine if our surgical weight loss program meets your insurance guidelines. We also work closely with you and your insurance company to maximize your benefits under your existing plan.
Insurance Authorization Process
All of the above documentation is submitted to your insurance company in order to obtain an authorization for coverage of the surgical weight loss procedure. Please note, insurance companies can take between 4 and 6 weeks to respond.
You can count on the health care professionals at Florida Surgical Weight Loss Centers to guide and support you throughout every stage of your weight loss journey. Take the first step to a healthier and happier you by contacting us today.