Insurance & Financial Information
Insurance coverage is an important aspect for patients to understand. The easiest way to know if your insurance will pay for bariatric related care is to call them and ask. You will need to call the customer service or benefits number listed on your insurance card, and ask the insurance representative if your policy has an “exclusion for the surgical treatment of morbid obesity”. If there is an exclusion on the policy, they will not pay for the clinic visit or surgery regardless of any other medical problems you may have related to obesity.
If the insurance representative tells you they cover surgical treatment of obesity if medically necessary, this usually means that they will cover the treatment if you meet their criteria. The fact that your physician feels that surgery is medically necessary does not guarantee that your insurance company will agree; you must meet their criteria. It is very helpful to find out the criteria and work on getting all the required information together before being seen the bariatric surgery clinic. Some of the insurance company's requirements may include the following:
- Psychological evaluation
- Primary care letter of support
- Nutrition Consult
- Diet history – which includes: Medically supervised diet by a doctor, at least 6 months to one year (varies by insurance plan)
Please remember every insurance company is different and may require different forms of information.
If you do not have insurance, or your insurance will not cover bariatric surgery, you have the option to pay for the bariatric surgery services. Please call our Bariatric Scheduling Coordinator (503) 494-1983 for price information.
Our policy requires that all visits must be paid in full prior to the service, and that the surgery fee (including surgery, anesthesia and hospitalization) is required two weeks prior to the date of surgery.
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