Paying For Surgery

Weight loss surgery is often the best or only treatment option for many patients, but the cost of any major operation and associated care can be quite high. Fortunately, many insurance companies offer full or partial coverage for bariatric surgery, and a number of self-payment and financing options are also available through Kettering Bariatrics and our lending partners.

Self-Pay 
Patients can simply pay the program directly for surgery and associated charges, either in itemized form or as part of a global fee.

Insurance Issues
Weight loss surgery is increasingly common and recognized as a highly effective treatment for morbid obesity. Many major insurance companies offer full or partial coverage for surgery. For example, Aetna , Blue Cross-Blue Shield, Cigna, Anthem, and Medicare all routinely authorize bariatric surgery. Before you schedule the surgery, however, you must secure official authorization from your insurance company for the procedure you have chosen (or chosen one of the above payment/financing options). 

Getting Certified
Insurance companies and individual policies are all different, but the process for authorizing surgery is fairly common. You can expect to do some or all of the following:

1) Call your insurance company and ask to speak to someone who can explain your coverage in detail, and outline the requirements for authorizing weight loss surgery.

  • Ask whether your policy covers weight loss surgery. If so, which specific procedures are included and are any excluded? Is your coverage valid at Kettering or Sycamore Hospitals with the surgeon you've chosen?
  • Find out what portion of the cost your policy will cover. Are pre- and post-surgery services such as diet counseling, exercise consultations and physician office visits included?
  • Ask what the requirements are for pre-authorization of the surgery. These often include medical reports, a primary care physician's referral and additional paperwork.
  • You may want to inquire about the average timeframe for securing approval and any common reasons for rejection that you may be able to avoid.

2) Schedule a visit with your primary care physician to secure one, many or all of the following:

  • An official referral to Weight Loss Surgery at Kettering and Sycamore Hospitals and/ or to a participating surgeon .
  • Medical records establishing a history of obesity and the failure of more traditional weight loss treatments.
  • A letter stating the surgery is medically necessary and the best or only course of treatment available.