St. Luke's Bariatric Services

Insurance

Insurance

Verify Coverage

Before committing to gastric bypass surgery, you should call your insurance company and verify that you will have health insurance coverage for Laparoscopic Gastric Bypass or Adjustable Gastric Lap Banding. Most insurance cards will have a “benefits line” phone number on the back. Call that number and ask if you have the benefit for either of the following:

  • Procedure code 43644, which is the Laparoscopic Gastric Bypass code, or
  • Procedure code 43770, which is the Laparoscopic Adjustable Gastric Band code
  • Procedure code 43775, which is the Sleeve Gastrectomy code. Not all insurance companies cover the Sleeve even if  you have the benefit for weight loss surgery in your plan.  

While you are speaking with your insurance provider, ask the representative what your financial responsibility will be as many plans have deductibles or co-pays.

Authorization Process

Our program requires a psychological evaluation and nutrition evaluation by our team members prior to approval for surgery. Most insurance providers require this too. Many insurance providers require that a six-month nutrition and exercise program be followed prior to approval, while others may require a shorter process. Depending on your medical history, you may be required to consult with specialists, for example a cardiologist or pulmonologist, prior to being approved for surgery.

You will receive a manual by our precertification specialist. In addition to all the information about your procedure, this manual will provide lesson plans that you must complete prior to approval. These lesson plans will help you start your journey to a healthier way of living and prepare your body for a smoother surgical procedure. Part of that healthier plan will include quitting tobacco use, increasing activity and starting some of the rules, that when adhered to after surgery, will increase your success.

You should start documenting all previous weight loss attempts and diets. This will be an important part of the insurance approval process. You may have an out-of-pocket expense or deductible depending on your plan, so be certain to know what your insurance requires. All deductibles and out-of-pocket expenses will need to be paid in full prior to your surgery date.