Does United Healthcare Cover Weightloss Surgery?
Does United Healthcare cover weightloss surgery? People who want to lose weight often think first about their insurance coverage and how much it will cost. Planning for bariatric surgery can be hard, but our team of board-certified bariatric surgeons in Jacksonville, Florida, is experienced and ready to help you through the process so that your surgery goes well. United Healthcare, one of the biggest insurance companies in Florida, has a lot of different plans to choose from. This can be done through an employer plan or a private plan that you pay for yourself. Depending on your plan (individual, family, or Medicare), weight loss surgery may be covered. Most UHC insurance plans let you use Memorial Advanced Surgery.
This means that your out-of-pocket costs will be less than if you went to a doctor who is not in United Healthcare’s network. For weight loss surgery to be covered by insurance, the patient usually has to meet certain guidelines and submit medical proof. Working with an experienced bariatric program, like the one at Memorial Advanced Surgery, can help you move through the steps of getting weight loss surgery covered by your UHC plan quickly and with confidence.
How Does United Healthcare Cover Weightloss Surgery?
When a policy doesn’t cover a certain procedure, it will usually say so. This is called a policy exclusion. We suggest that you read your policy documents and call United Healthcare’s customer service to find out if this is the case. We recommend that anyone who wants to lose weight through surgery contact United Healthcare directly to find out if they cover bariatric surgery. Our team checks each patient’s benefits, and we ask that you do the same. On the back of your insurance card, there should be a phone number you can call. This is the best way to talk about your policy and coverage with a UHC representative.
If you have insurance through your job, you may also want to talk to the benefits manager in your HR department. Some policies do not cover weight loss surgery. However, this is not the norm. It’s a good idea to check on your weight loss surgery coverage as soon as possible to avoid surprises or extra costs later.
United Healthcare Cover Weightloss Surgery Policy
Most UHC policies have a separate section that explains in detail which bariatric procedures cover and which ones are not. This section should also make it clear what the rules are for coverage. Or, what a patient must do to be eligible for coverage. We use these rules to help make sure that UHC gives us a prior authorization. Prior authorization is not a guarantee that your insurance company will cover the cost, but it is a good sign that the rules have been followed.
Your policy is one of a kind and can be different from other plans from one year to the next. We tell people who want to have weight loss surgery to only use the information in your policy. We encourage anyone interested in bariatric treatment to get in touch with both our office and United Healthcare to learn more about how weight loss surgery is covered.
How Much Does United Healthcare Cover Weightloss Surgery Cost?
How much you’ll pay can look different for each patient. Also, how a policy has set up and how much other money has spent on healthcare can affect how much a patient has to pay. When making plans for surgery, you need to think about copays, coinsurance, individual and family deductibles, and/or an out-of-pocket max. Also, keep in mind that the amount you still owe on each may change as you pay for medical bills throughout the year. If you finish the process before the end of the year, you may have less money out of pocket. Because you paid for other things during the year.
Most of the time, being eligible for coverage for a certain weight loss treatment doesn’t mean that it will pay for in full. However, if you’ve reached your out-of-pocket maximum for the year, this may be the case. Our bariatric team will take the time to meet with you and talk about your United Healthcare benefits.
Do You Have To Pay To Get United Healthcare Coverage For Weight Loss?
What your policy needs to cover bariatric surgery may be a little different. In general, pre-approval is based on the following things. You can look at your policy to see if your specific criteria are there:
- BMI of 40 or more, or 35 or more if you have a related health problem
- A diagnosis of obesity
- Formal records of past attempts to lose weight, which may require a weight loss program supervised by a doctor.
- At least eight weeks before surgery, a person must stop smoking.
Which Bariatric Procedures Are Covered By United Healthcare Florida?
Most of the time, UHC policies cover the main bariatric procedures. These include the sleeve gastrectomy, the Roux-en-Y gastric bypass, and the duodenal switch. Lap-Band may also cover by some policies, but we don’t do this procedure very often. United Healthcare will not pay for certain experimental procedures. Such as the mini-gastric bypass, intragastric balloon, and cases with a lower BMI.
Sometimes its possible to see patients already had bariatric surgery but haven’t reached goals. So they need another surgery to lose weight. The rules for covering a second weight loss surgery may be stricter. So, a patient’s medical record must often show that the reason the first surgery didn’t work. Patients who have had bariatric surgery in the past and want to change their procedure should contact our office.
Even though research shows that bariatric surgery works, some insurance policies don’t cover it as a way to treat obesity. We have carefully put together a full self-pay program for patients who don’t have bariatric insurance. We also work with third-party financing options to help people who don’t have insurance. Self-pay is also a good option for people who want the best bariatric care. However, don’t want to deal with insurance’s strict rules.
Does United Healthcare Cover Gastric Sleeve or Do I Have to Pay for Whole?
If you are wondering the answer to “does united healthcare cover gastric sleeve?” some United Healthcare plans may provide coverage for the entire procedure, while others may only cover a portion. Gastric sleeve surgery is a standard weight-loss procedure that helps people reduce their amount of food intake. It involves surgically removing a large portion of the stomach to limit the amount of food that can be eaten at once. The remaining stomach is reshaped into a tube-like shape (hence the term “sleeve”), and this new stomach can only hold about one cup of food at a time.
Does insurance cover gastric sleeve in general? When investigating coverage for gastric sleeve surgery, it is important to be aware of the potential out-of-pocket costs associated with the procedure. These costs can include medications, pre-operative tests, follow-up care and nutritional counseling. Although United Healthcare may cover the cost of the surgery itself, it may not cover all of these additional expenses.
The best way to determine the answer to “does united healthcare cover gastric sleeve?” is to contact your health plan provider directly. They will be able to provide you with detailed information about your coverage and any potential out-of-pocket costs that you may be responsible for paying.
