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Cypress Bariatric & General Surgery Patient Resources: Important Insurance Verification Information
 Insurance Verification To determine if your insurance policy covers obesity (or "bariatric") surgery, refer to the insurance policy package that you have received after paying your first premium or provided through a plan offered by your employer. Typically, there are two sections that describe the extent and limits of coverage. The first is usually called "What Is Covered" or "Covered Expenses." These are the healthcare benefits for which the company will pay. The other section is "What Is Not Covered" or "When the Plan Does Not Pay Benefits." In this section, look for any statement that the company excludes coverage for weight control, for the treatment of obesity, for the surgery for weight control, or for the complications of the surgery for weight control. Some policies will outright exclude bariatric surgeries. Others may have certain parameters around which bariatric procedures they cover and how much of the costs they cover. Look for statements such as, "Surgery for the treatment of obesity is covered when deemed medically necessary," or "Surgery for the treatment of obesity is (specifically) excluded except when medically necessary." If this surgery is a covered benefit when medically necessary, then it should be covered when patients meet national guidelines for care for morbid obesity. Below is the list of companies that are known to either partially or completely cover LAP-BAND® System surgery in Texas. Please note that this list in no way insures that you will be covered -- it's provided for informational purposes only. Please note that this is not a comprehensive list. It is your responsibility to determine your particular level of coverage. Our office is always available to assist you. Call 281-640-8373. Submission Requirements A Letter of Medical Necessity and weigh-loss history are necessary to obtain prior authorization for obesity surgery. A Letter of Medical Necessity states why significant weight loss is medically necessary for a patient and usually includes the following information:
Appeals and Patient Financing If coverage has been denied upon the initial prior authorization request, you can appeal by addressing the specific reasons why your request has been denied. Please contact our office for additional information. You can also contact a lawyer with expertise to help you with the appeal. More information about legal help can be found at The Obesity Law and Advocacy website at www.obesitylaw.com. When insurance reimbursement is not available, patient financing is another alternative you may consider. Please ask us about available patient financing programs during the patient seminar or your office visit—-or view our patient financing information online. 
Keep Learning: Back to Patient Resources | Financing Options |
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Dr. Waggoner can display this Lap-Band® System Seal because he has performed at least 75 LAP-BAND® System procedures last year.
Are you a candidate for weight loss surgery with the LAP-BAND® System? 
Get informed! Dr. Waggoner is eager to answer all your questions on the Lap-Band® System.
There are so many things to consider when deciding whether or
not weight loss surgery is the best option. 