Everyone needs health insurance. But how do you decide what type of plan to buy? If you’re preparing for weight loss surgery, you should know that not every insurance company covers the procedures.
Some companies pay for some types of weight loss surgery. Others offer limited or no benefits for bariatric surgery.
At WeightWise, we’ll work with your insurance company to figure out what benefits you can expect. Learn more about paying for weight loss surgery by reading our financial FAQ page.
Weight loss surgery isn’t for every overweight person. The surgery is only for those with a body mass index (BMI) of 40 or higher, or someone with a BMI of 35 to 39 who also has a serious obesity-related disease such as diabetes, sleep apnea or high blood pressure.
How to Choose an Insurance Plan if You’re Having Weight Loss Surgery
Buying insurance can seem like an overwhelming decision. Before you make a decision, call the company and request information. Ask if the plan covers weight loss surgery. Ask about the qualifications and benefits.
Here are some things to consider before you settle on a plan:
What type of plan is best if I have a chronic condition?
If you are managing a chronic condition, you’ll likely use your health insurance a lot. People who visit the doctor regularly sometimes choose a plan with a higher monthly premium and lower deductible.
Should I get a plan with low monthly premiums?
Plans with a low monthly premium have a high annual deductible. These plans are for people who are in good health and seldom visit the doctor but want insurance in case of an accident or sudden illness.
What If I take a prescription drug regularly?
If you take a prescription drug to manage a chronic condition, be sure to read the plan’s formulary. If your drug isn’t on the list, you’ll have to pay for it out-of-pocket.
What’s the difference between the different types of managed care?
Insurance companies limit expenses by negotiating fees within a network of healthcare providers. To get the negotiated benefits, patients must choose a provider within the network. Getting care outside the network means you’ll pay more.
These are the three types of managed care:
- H.M.O. – a health maintenance organization covers care only from providers in the network.
- P.P. O. – a preferred provider organization also has a network. You’ll receive a lower rate for benefits if you see someone outside the network.
- P.O.S. – point of service combines characteristics of an H.M.O. and a P.P.O.
How can I find out about a plan’s costs?
A plan’s “summary of benefits” describes the various costs and benefits. Check a plan’s co-pays, maximum out-of-pocket limits and other expenses.
To learn more about your options for weight loss surgery, please attend a free informational seminar sponsored by WeightWise.