Insurance and Coverage of Obesity Treatment*
Insurances Accepted by Dr. Marvin:
BCBS of Texas
Coventry Health Care
United Health Care
Bariatric Coverage Overview
At Houston Surgical Specialist our insurance verification coordinator will determine the bariatric benefits through medical insurance coverage prior to the initial consultation. Once verified, the expert staff will notify the patient to discuss the benefit coverage options available. For many, weight loss surgery is affordable through health insurance. Some employer plans may have exclusions, restrictions or full benefits. You may complete the Contact Us section to the right of this page to request a bariatric benefits verification or call the staff at 713-993-7124.
How much does surgery cost if my insurance will not pay for it, or I do not have health insurance?
At HSS we believe that financial barriers should not stand in the way of a healthy life. Should you not have medical insurance coverage for weight loss surgery, there may be other options available to help with the cost. During the initial consultation, Dr. Marvin will discuss all the surgery options and which may be best suited for you. Cost vary based on procedure and hospital location and we will be happy to review the options available with you at that time.
What are exclusions on my insurance policy?
The term exclusions are used by insurance companies and employers to place holds, limitations or certain required steps prior to weight loss surgery. This can be a session with a psychologist, a registered dietitian or a 6 months medically supervised weight loss plan.
Does weight loss surgery require frequent visits with my surgeon after surgery?
The follow up visits required by Dr. Marvin are as follows: 1 week, 1 month, 3 months, 6 months, 1 year and each year thereafter. During each visit Dr. Marvin will order labs to be performed in office to ensure there aren’t any vitamin deficiencies or other concerns. Typically, the visit and labs are covered under standard copay and coverage. This varies per insurance policy.
Why do I need a psychological evaluation before surgery?
Many employer insurance policies have exclusions requiring all weight loss surgery patients to see a psychologist prior to authorization. Dr. Marvin also feels this is important to insure the commitment level of the patient to make this life changing journey.
Does insurance cover other testing, such as a sleep study or cardiac testing?
Again, many policies differ, insurance may cover these appointments.
How can I support bariatric surgery insurance coverage with my employer?
The best way a patient can alter the system is to take the matter up with the HR department at their company. The employer has chosen to exclude obesity surgery under the plan. By letting the employer know that the employee expects complete coverage for life threatening medical problems part of their health care benefit, the employee is most likely to end the cycle of denial of this necessary care.