Insurance Coverage

Did you know that most LAP BAND(r) and Gastric Bypass cases are covered by insurance?

The reason for the question is it’s one of the biggest concerns that we hear from people who are thinking about the LAP BAND(r) or Gastric Bypass and it can be a deciding factor in moving forward with the procedure. Many patients wonder, “Are bariatric procedures too expensive?” Well, that’s what many others have thought – before they found out that insurance covered it.

That’s right. Many insurance companies do cover the procedures and you can find out if yours is one of them fairly easily.

So how do you find out if your insurance company will cover it and if you qualify for the procedure?

Call our office and ask to speak with one of our expert billing professionals! We can answer ALL of your insurance questions!

Another option available is visiting www.lapband.com. Once enrolled in My Lap Band Journey you’ll have access to an online tool that will do a preliminary screen to help you determine whether your insurance will cover the surgery. To check out the new insurance tool, please visit the LAP BAND(r) financing page.


What if they don’t cover it? What can you do then?

One option is to appeal your case. If your request for prior authorization for the LAP-BAND(r) System surgery is denied by your insurance company, you may have the opportunity for a limited number of appeals of this decision. The process varies according to the plan, so be sure to check your insurance company’s specific appeal policy. Generally, you can appeal if your denial is based on the following reasons: The LAP-BAND(r) System is investigational, The LAP-BAND(r) System is experimental, or the insurance company has no previous knowledge of the LAP-BAND(r) System. The LAP-BAND(r) website has several downloadable resources to help you with your appeal, including: a patient guide to insurance appeals and a sample letter of medical necessity. These documents can be found at the LAP BAND(r) resource center

Another option is to finance the procedure. If your doctor is a participant in the LAP-BAND(r) System Patient Finance Program, you are eligible to apply for CareCredit(r), which is the nation’s leading patient financing program. If your doctor is not a participant, he/she can easily enroll in this program by contacting his or her LAP-BAND(r) System Account Manager. CareCredit(r) provides a choice of convenient monthly payment plans designed to help patients pay for healthcare expenses not covered by insurance, including co-payments, deductibles, and elective treatment. Upon request and approval, CareCredit(r) can help cover medical fees. Patients can choose from two types of payment plans: Low-Interest Payment Plans or No-Interest Payment Plans. Learn more about the CareCredit(r) program for LAP-BAND(r) here.

If you have any questions or would like to make an appointment to see one of our surgeons, call our office at (516) 616-5500 or fill out our contact formto start a conversation now.

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Insurance Coverage

Thomas

Lost 145lbs

Thomas' success story

I went in for surgery. An hour later, I came out a new man.

Everybody treated me like a king. The day of surgery, I was excited. The hospital couldn’t be any nicer. I went in for surgery. An hour later, I came out a new man. My recovery was awesome. I was out of bed that day. My wife and kids were my motivation on getting this surgery. They are my whole life. I’m happy I’m going to be around for them.

Listen to Thomas’ testimonial

Nicole

Lost 76lbs

Nicole's success story

I hit my goal weight ... and I feel fabulous

I had the gastric bypass. I am Type 2 Diabetic and I wanted to gain control of my sugar. I hit my goal weight in about 5 and half months and I feel fabulous. The procedure has completely changed my life for the better because it has empowered me as a middle aged woman that I can really do everything and anything that I want to do. I don't put an age on anything. I don't say I'm too old for something.

Listen to Nicole’s testimonial

Robert

Lost 76lbs

Robert's success story

I was tired of the way I looked. I was tired of the way I felt.

I knew if I didn't change something soon, I was going to be in a lot of trouble. The consultation process was a lot easier than I expected. I was met with open arms. I was treated like I was the only patient here. Not only did they answer all of my questions, they had questions for me to make sure I was the right candidate for the surgery. After surgery and that weight started dropping off, my life started changing for the better.

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Samantha

Lost 92lbs

Samantha's success story

I feel like a completely different person.

I had the gastric sleeve procedure. The driving factor behind me getting this procedure was my health. I didn't feel good physically or mentally. I had joint pains, even standing was difficult sometimes. Emotionally, this surgery completely turned my life around. I have so much more confidence. So much more happiness. I feel like a completely different person. I feel stronger. I feel able to accomplish more.

Listen to Samantha’s testimonial

Eileen

Lost 99lbs

Eileen's success story

It saved my life.

The driving factor behind me getting my procedure was that I couldn't get up off the floor with my granddaughter. That was my why. That was my big reason for having this surgery done. After surgery, it was a little bit of a struggle with what to eat. What you put in your mouth that you don't even think about. You don't think about what you're eating or how you're eating and portion size. It's what I do now every single day. The procedure has changed my life in so many ways. It saved my life.

Listen to Eileen’s testimonial

Brittany

Lost 126lbs

Brittany's success story

I am totally comfortable in my own skin.

I think I always grew up identifying myself as less than other people because I was fat. I decided to tackle that and just live my life. I had a sleeve gastrectomy. It changed how I view myself. How I communicate with people. I'm able to be much more of myself and live the life I always thought I should have been living. I am totally comfortable in my own skin. You have the tools you need to succeed here.

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Desiree

Lost 157lbs

Desiree's success story

I have a brand new life. I can do things I couldn't do before.

I had a vertical sleeve gastrectomy because I had just become diabetic, and I had hypertension for many years. I lost a total of 157 pounds in 11 months. I have a brand new life. I can do things I couldn't do before. Everyone at New York Bariatric Group has been wonderful. They are kind. They are understanding. They make you feel comfortable. They will guide you every step of the way on your journey so that you can be successful.

Listen to Desiree’s testimonial

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Note: A BMI of 30 – 34.9 or BMI 35 – 39.9 with no comorbidities qualify for lap band but is usually not covered by insurance.

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