Insurance For Weight Loss Surgery

One of the first steps YOU should take is to find out if you have coverage under your health care plan for weight loss surgery. You can find this out by contacting your benefits department with the number listed on your insurance card. Don’t be afraid to ask questions of your company representative – after all, this is your contract for health care benefits and you have the right to know what is available to you. Ask about coverage for weight loss surgery, specifying the surgery you desire (gastric bypass or LapBand gastric banding.) You should also ask specifically if you have any exclusions to weight loss surgery on your plan. This can be a separate issue from coverage and an important one, particularly if you are a Blue Cross Blue Shield, Coventry or United Health Care** member. Be sure to write down exactly what information your representative gives you, and who you talked to in case there is a question later.

** For UHC members:  It is important for you to find out if you have coverage for weight loss surgery as well as a separate exclusion for weight loss surgery on your health care plan. However, if you contact your company representatives by telephone you may not receive accurate information. Please find a written copy of your exclusions, either in a booklet or on-line and review the list for either “gastric bypass surgery” or “weight loss surgery.” If the exclusions list “weight loss programs,” then surgeries should be a covered benefit.  If you are unable to find anything about exclusions on your policy, then we will do our best to help you even without this information. 

For all patients, while on the phone with your benefits representative, you should also review what benefits you have for inpatient surgery (gastric bypass) or outpatient surgery (LapBand) i.e. what annual deductible you have, what your maximum out-of-pocket is, etc. You will be expected to pay the usual co-pay amounts for office visits to our surgeons as specialists before your surgery. You should be aware of whether our surgeons or the hospital(s) are in- or out-of–network with your insurance plan as well. We will keep you informed to the best of our knowledge but it is ultimately your responsibility to keep track of the in-network status of all providers, consultations, labwork, and facilities used in the weight loss surgery process. Our surgeons perform both the inpatient laparoscopic gastric bypass surgery and the LapBand gastric banding at Shawnee Mission Medical Center in Shawnee Mission, Kansas and outpatient LapBand gastric banding surgery at Heartland Spine and Specialty Hospital in Overland Park, Kansas. If you have any questions about whether our practice or the facilities are in-network or out-of-network under your plan, you should contact your insurance company or check your insurance handbook.

We are pleased to announce that on January 22, 2007

        Bariatric Center of Kansas City

and Shawnee Mission Medical Center

became a

    Bariatric Surgery Center of Excellence

as recognized by the

American Society of and Metabolic Bariatric Surgery

       and the Surgical Review Corporation

Specific Insurance Plans

The Bariatric Center of Kansas City does not contract as a separate entity with the insurance plans to provide surgical care for patients.  Instead, the contracts are under the names of our surgeons, Dr. Stanley Hoehn, and Dr. C. Thomas Hitchcock.  Your insurance plan may recognize our program as a Center of Excellence or as a Center of Distinction, however.  But if you are calling to find out if we are in-network under your plan, be sure to ask using the names of one of our surgeons, not the name of the program. You should always check to see if the hospital is in-network as well. Again, our surgeons perform surgery at Shawnee Mission Medical Care in Shawnee Mission, Kansas and Heartland Spine and Specialty Hospital in Overland Park Kansas. 

Our surgeons participate with many, many insurance plans, essentially too many to list, and the list is constantly changing!  Below is a list of the most frequently seen plans, but remember that this list is NOT ALL INCLUSIVE and you should ASK your company if our surgeons are in-network under your plan if you don't see your plan listed. Our contracts are constantly changing, and plans are being added and modified frequently by the insurance companies. 

• United Healthcare
• Aetna  (effective 5/1/2008)
• Blue Cross/Blue Shield: Federal, Local, In and Out of State
• Humana - Choice Care only
• Medicare, as non-contracted provider, see below
• Private Healthcare Systems
• Cigna
• AARP
• Coventry
• First Health
• Freedom Network
• Epoch
• Great West
• Multiplan
• Sprint UHC plans
• Tricare Standard and Tricare for Life (NOT PRIME)
• Wellmark

Attention Medicare Patients:

                  Medicare currently provides coverage for two forms of weight loss surgery that we

             offer: the LapBand Gastric Banding and the Laparoscopic Roux-en-Y Gastric Bypass

             surgeries.  Medicare requires that all Medicare subscribers must have their surgeries

             performed by surgeons and at hospital programs that have been designated as ASBS

             Surgical Centers of Excellence. 

             Our surgeons are working with Medicare patients up to the age of 72 that we

             consider are good candidates for weight loss surgery.  However, our surgeons are

             non-contracted Medicare provicers, which means that they will not be accepting

             Medicare assignment.  If you have a secondary that covers weight loss surgery or

Medigap plan, these may be helpful in covering the unassigned amount of charges.  When you register for your informational seminar, we will

             be sending you detailed information about this, and will also discuss this at our

             insurance/financial session in the hour before the official seminar begins.

             It is important for Medicare subscribers to know that Shawnee Mission Medical Center

             is a Bariatric Surgery Center of Excellence and DOES accepts Medicare assignment.

So Now What?

Once you’ve determined that you’ve got coverage for weight loss surgery under your insurance plan, or you’ve worked out your financial arrangements, you’re ready to move forward with the next step: How to Begin.