Gastric Bypass Surgery – Will Your Insurance Cover It?
Gastric bypass surgery can cost from $25,000 to $35,000 - and can go over $100,000 if there are complications. Naturally, most people who are considering this procedure as a treatement for obesity will be wondering if it is covered by their insurance. A new report helps them find out.
(PRWEB) July 12, 2005 -- If you're wondering if gastric bypass surgery is
covered by your policy, “you should read your benefit booklet and understand
your rights before you call your health insurance carrier,” according to Jonni
Good, a customer service specialist with a large health insurance company, and
the owner of http://www.stress-free-weight-loss.com.
When people
begin to consider gastric bypass surgery as a treatment of obesity, one of the
most pressing questions is “will my insurance cover it?” The surgery itself can
cost from $25,000.00 to $35,000.00. If there are complications, the costs can
skyrocket to over $100,000.00.
Unfortunately, it is not easy for the
average policy-owner to understand his or her benefits for gastric bypass
surgery. Many health insurance policies specifically exclude gastric bypass
surgery from benefits because of the high costs and common complications for
this procedure. Even when the procedure is covered by their insurance, many
people may not understand the pre-authorization requirements or the medical
policies that are used to determine eligibility.
Ms. Good has just
released a 12-page online report titled “Gastric Bypass Surgery and Health
Insurance” to help her readers understand their benefits and rights. The report
answers many of the questions that are asked by health insurance customers who
are considering gastric bypass surgery, and explains many commonly misunderstood
terms, such as “contract exclusion,” “pre-authorization,” and “medical
necessity.”
This report also helps readers find a copy of their insurance
company's official medical policy on bariatric surgery. “If the surgery itself
is eligible for benefits, you will still have to meet the criteria found in the
medical policy before your own surgery will be covered,” ccording to Ms. Good,
so it's important to read the medical policy and discuss it with your doctor
before you talk to your insurance company. Most insurance companies use the
gastric bypass criteria from National Institutes of Health, which are available
online at http://win.niddk.nih.gov/publications/gastric.htm but they may
add other requirements, such as a trial period of medically supervised diet and
exercise.
If your insurance company makes a mistake and turns down your
request for surgery even though you meet all their criteria, you may need to
file an appeal. Ms. Good's report helps you find out what you need to do in
order to appeal your insurance company’s decision.
The full report can be
found at http://www.stress-free-weight-loss.com/health-insurance.htm
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Source : http://www.prweb.com/releases/2005/7/prweb260269.htm