It is important to check with your insurance company prior to starting this process. Call the toll-free number listed on your insurance card for either benefits or customer service and ask the following questions:
- Ask if the procedure code 43770 (LapBand®) or 43775 (sleeve gastrectomy) is a covered benefit. Be sure to clarify that you are asking about the procedure on the basis of medical necessity.
- Do you have any specific criteria that must be met to have weight loss surgery?
- Are my surgeon and Boone Hospital Center providers under my plan?
- Are nutrition, physical therapy and psychological evaluations covered?
Not all insurance plans have a benefit for weight loss surgery. If the insurance company states that it is covered based upon medical necessity, the surgeon will write a letter to your insurance company describing why you specifically need the surgery done. If the insurance company instructs you that you have a contract exclusion or that it is not a covered benefit then you will need to be able to financially cover the cost on your own.
Boone Hospital has arranged an affordable self-pay price for individuals without insurance coverage. If self-payment is elected, payment is required in advance of your surgery date for this elective procedure.
Here are some local organizations that do cover weight loss surgery in their insurance plans:
BCBS IL employees
City of Columbia
Columbia Public Schools
Dialysis Clinic Inc.
Federal Postal Workers
IUOE Local 965
Missouri Banker’s Association
Moberly Area Community College
Morgan Co RII Schools
MoKan Sheet Metal
Northeast Regional Medical Center
State of MO
University of Missouri-PPO