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Will my insurance company cover the LAP-BAND/REALIZE Band procedure?

In general, about 50% of insurance companies will cover the LAP-BAND/REALIZE Band procedure if requirements are met warranting a Letter of Medical Necessity (stating why significant weight loss is medically necessary, based on several health criteria).

Many states have laws that require insurance companies to grant benefits for weight loss procedures, providing the patient meets the criteria of the National Institutes of Health. However, comprehensive and detailed attention is usually needed in order to obtain insurance coverage for LAP-BAND/REALIZE Band surgery, which we will work diligently with you to complete.

Which insurance companies cover LAP-BAND/REALIZE Band and other weight loss surgeries?

Insurance companies that provide partial or complete coverage include: Blue Cross (in some states), Humana First Health, Medicare, United Healthcare, Aetna, Cigna, Luminos, PHCS.

Check with your employer’s human resource department or fill out one of our applications and our insurance verifier will look into your options.

What is a Letter of Medical Necessity?

It is necessary, before weight loss surgery authorization from an insurance company, to obtain a Letter of Medical Necessity as it pertains to your request for surgery. This letter addresses why weight loss is pertinent to the health of the patient, warranting surgery. Information in the Letter of Medical Necessity includes: diets/programs for weight loss tried in the past; weight of patient; obesity is usually determined to be 100 pounds over one’s ideal weight or a BMI of 40 (at least 35 BMI with additional medical issues). Years patient has been overweight, usually five years or more. Full history of medical problems related to obesity, including hypertension and type 2 diabetes.

If you have more questions about lap-band surgery or any other weight loss surgery procedure, please contact us or consider attending a free seminar. You can also contact us on Facebook or via Twitter.