Insurance and Financial Information
This is often times the most frustrating element for our patients throughout the surgical process. Our experts at Wesley Woodlawn will assist you navigate the insurance process as you begin your journey. The below information will help you get started, and if you have any questions, please do not hesitate to contact us at (316) 858-8921.
Many insurance plans cover bariatric surgery. The basic requirements most people need are:
- A letter of medical necessity from their primary care physician
- Three years of documented weight history
- Cardiac and pulmonary clearance
- A psychological evaluation
If you have insurance and are interested in bariatric surgery, please contact your insurance provider to determine if they will cover your desired procedure. We recommend you ask the following:
- Do you cover bariatric surgery?
- What procedures do you cover (bypass, band, sleeve)?
We also recommend that you record the individual you spoke with and the date/time of your conversation. If you have any questions or concerns, do not hesitate to contact us and a bariatric coordinator will assist you.
For individuals who are 65 and older and have Medicare coverage, we are now offering our bariatric surgical and support programs. Seniors often deal with an array of health challenges, and we look forward to partnering with you to increase your quality of life and decrease your health risks associated with obesity. We are experienced in caring for Medicare patients, and we’ll be able to assist you in navigating your insurance, financial and support-group needs.
Wesley Woodlawn Hospital & ER is the first and only hospital in Kansas to earn the NICHE (Nurses Improving Care for Healthsystem Elders) certification. NICHE is the leading nurse-driven program designed to help hospitals provide sensitive and exemplary care to all patients 65 and older.
Guidelines and qualifications
The below guidelines provide general technical qualifications used by Medicare and/or other insurance companies. Use the below indications to understand what may determine whether you are a good candidate for bariatric surgery and whether you may receive potential insurance coverage.
- BMI of 40 or greater (approximately 80-100 pounds over ideal body weight) – or BMI of 35+ with associated comorbidities (medical problems associated with and/or caused by obesity). Check your BMI with our calculator. Medicare requires a documents
- Significant previous efforts at weight loss have been made. Preferably, these attempts have been in nutritionally safe and medically or peer-supervised programs.
- No uncorrected metabolic disease that may cause obesity.
- No other serious medical condition(s) that would make surgery too hazardous.
- No unstable or untreated psychological illnesses and/or unrealistic expectations of surgery and weight loss.
- No abuse of addictive drugs or alcohol—preferably for at least 12 months.
- Sufficient motivation to make the life-long changes in eating habits and exercise required for success after bariatric surgery.
- Willingness to make a formal commitment to yourself and to the bariatric surgical procedure you will choose with your surgeon’s guidance.