Questions to Ask Your Insurance Company
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Published: May 29, 2007
Updated: Oct. 28, 2008
- Is morbid obesity a covered benefit in your policy? Give them the ICD9 Code of 278.01. If morbid obesity is a covered benefit, check that the operative procedure you are considering is also covered. For the Roux-en-Y procedure give them the CPT Code of 43846 or 43644 and for the Lap-Band® Procedure give them the CPT Code of: 43659 (Note that many insurance companies do not yet approve the Lap-Band Procedure so check carefully with your company if this is your selection). Finally ask if Duke University Health System and Durham Regional Hospital are accepted by your insurance.
- What percent of the total bill will you be responsible for and is there a deductible that you will need to pay?
- If your policy does not cover morbid obesity or the operative procedure, you have a couple of options:
- You have the option to obtain another insurance carrier, but you need to make sure that the new policy covers morbid obesity and the surgical procedure.
- You can continue to participate in medical programs designed to lose and maintain weight loss.
- In selected cases we will consider performing the surgery if you elect to self-pay. There is a considerable deposit required by the hospital and you must fully understand all risks of financial burden. We will review this major decision with you extensively and will help in any way we can.
If you cannot understand the information given by your insurance company on coverage of obesity care, please feel free to contact our insurance specialist Ms. Brenda Fisher at 919-660-2229 ext. 0 for an in-depth review of your policy.
Patient Manual Index
- Questions to Ask Your Insurance Company
