Depending on your insurance, you may need to meet minimum requirements or more extensive selection criteria. Your insurance provider will be the best source of information, and our staff can help you with their requests. For more information or to register for our free seminar call (269) 687-4673.
Am I a candidate for weight loss surgery?
Prior to any weight loss surgery, your doctor will give you a complete medical exam and assess your overall health. Psychological evaluations are part of the process. Part of the success of the surgery is the patient's commitment to continue the weight loss maintenance program afterwards. Most often this is demonstrated by progress in weight loss before the surgery.
If you are not ready to make these lifestyle changes, you will not be considered eligible for the surgery, because it will not be a success for you. Bariatric surgery is not a quick fix for obesity. Your commitment to diet and exercise must be strong, because you will need to adhere to the lifestyle changes after the surgery. Otherwise, complications from the surgery are likely to develop.
How soon can I have bariatric surgery?
The amount of preparation time is different for each person. The time in pre-surgery is sometimes determined by your insurance carrier. Most insurance providers require a certain number of months when you faithfully attend classes and medical appointments that focus on lifestyle changes regarding diet and exercise.
This usually includes:
- Complete medical examinations
- Psychological evaluation
- Sleep study
- Stress test
- Documentation of an exercise program
- Documentation of nutritional counseling
- Regular weigh-ins by your doctor
If I lose weight, will I be denied the surgery?
Most bariatric patients will not lose enough weight to be denied surgery. Any amount of weight you lose makes you a better patient by making it easier for the surgeon to perform the procedure. Losing weight also demonstrates to the surgeon and the insurance provider that you are serious about changing your lifestyle and eating behaviors.
After the surgery, how soon can I return to work?
You should take at least two weeks off work. If your job involves heavy lifting you may need to wait longer, possibly six weeks. Some employers will allow you to return to work earlier, but with restrictions.
After surgery, how often do I have to follow up?
Your doctor will work out a schedule with you. For the first year, you will likely be back for checkups at two weeks, six weeks, then every three months for another year. The doctor wants to make sure you are not developing any nutritional deficiencies and are losing the right amount of weight.
What questions should I ask my insurance provider?
- Is bariatric surgery covered through my benefit package?
- Am I required to have bariatric surgery at a hospital that has been accredited under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®)?
- Will the procedure be covered if it is performed at Lakeland Hospital in Niles?
- Is prior authorization required? If so, whom does the hospital and the surgeon contact to furnish the appropriate information? What phone number should they call?
- Do you require a second opinion before authorizing me to have the surgery?
- How much will I have to pay out of pocket for the surgery?
- Is there a different out of pocket expense for the hospital and the surgeon?
- Is there a maximum out-of-pocket expense?
- Am I required to participate in weight loss programs and nutritional counseling before being authorized for the surgery? If so, for how long?
- Am I required to attend support groups or counseling before the procedure? If so, for how long? Are any of these requirements covered in my benefit package?
- What kinds of tests do I need to obtain approval for the surgery?
If your employer offers a flexible spending account, you may be able to deduct funds for the out-of-pocket costs in advance from each paycheck, and receive a tax deduction as well. If your employer offers short-term disability insurance, you may be eligible to obtain benefits while you recover from surgery. Your employer can best answer how many weeks it takes before the disability insurance begins and how long it lasts.
If your insurance provider does not cover bariatric surgery, or if you do not have insurance coverage, Lakeland has a self-pay option. For more information, call (800) 420-1472.