Financial Services
Not surprisingly, two of the most common questions about the LAP-BAND System are: “Can I afford this surgery? " and "Does insurance cover it?”
The LAP-BAND System is regarded as the most affordable weight-loss surgery option (it also has a lower risk of mortality and side effects). In considering the expense of surgery, it’s important to first consider the cost of not having surgery . . . in other words, the cost of obesity. The following outlines what an average person living with obesity might spend each year.
References:
1 Health Management Research Center, University of Michigan, 2001
2 U.S. Bureau of Labor Statistics, Consumer Expenditures in 2006
3 Source: Colditz, GA, “Economic Costs of Obesity and Inactivity,” Med Science Sports Exercise, 1999
4 Marketdata Enterprises, Inc., 10/02
5 Bureau of Labor Statistics, Consumer Expenditures in 2006
When you compare the recurring annual costs of living with obesity to the cost of the LAP-BAND procedure, the question should be: "How can you afford not to have this surgery?"
How much does the LAP-BAND System cost?
The cost of LAP-BAND surgery depends on your individual needs. It’s determined, in part, by your specific medical history and health conditions. If you decide the LAP-BAND System makes sense for you, we will schedule you for a medical consultation in our center. After meeting with your physician, we will be able to personalize a care program and estimate your costs.
The charges for our services are the same for all patients. However, your actual out-of-pocket costs for the surgery will differ depending on your individual situation.
Does insurance cover LAP-BAND surgery?
Fortunately, many insurance companies recognize the serious health threats of obesity and do cover the LAP-BAND System. If you have insurance and your health benefits cover the LAP-BAND procedure, your out-of-pocket expenses will be determined by:
- Your deductible, co-payment amounts and any other co-insurance amounts
- The terms of any contracts Malley Surgical may have with your insurer
- Other factors specific to your situation
When you have your medical consultation, we can review your insurance benefits and help explain the coverage as well as estimate any out-of-pocket costs you may incur for the surgery.
What are my options if I don’t have insurance coverage?
At Malley Surgical, we are committed to helping people with obesity turn the page to a new life. It’s our goal to find a way to help you.
If you don’t have insurance or your insurance does not cover the LAP-BAND System, we will work with you to make the LAP-BAND surgery feasible for you as a self-pay patient.
We have a discounted global package available for self pay patients (patients who are uninsured or whose insurance policies do not cover the LAP-BAND System)
We also offer free referrals to financing companies and local banks who specialize in qualifying LAP-BAND patients for a variety of loans that allow you to have the surgery today and pay over time. Last, we can help you analyze your costs for surgery versus living with the costs of obesity.
In addition to the estimated annual savings opportunity of obesity-related costs totaling more than $18,000, you may also benefit from thousands of dollars in potential tax savings. A tax payer can now claim weight-loss expenses as a medical deduction, and savings of $2,000 to $4,000 are common.
When you have your medical consultation, one of our financial counselors will meet with you to discuss our self-pay programs.
How do I verify my insurance coverage?
Many insurance companies cover bariatric weight-loss surgeries, including the LAP-BAND procedure; some do not. Others will allow surgery based on specific parameters, for example, if surgery is deemed medically necessary or if you meet the national guidelines for morbid obesity.
Part of the benefit of attending our educational seminars is that we will contact your insurance provider to determine if you have the benefit that covers the LAP-BAND System.
How do I pursue authorization from my insurance company?
Your insurance company will want to verify that you genuinely need the surgery for health and well being. Because of this, it’s likely you will need to get authorization from your insurance company for the surgery.
To obtain authorization, you will need to submit a Letter of Medical Necessity. This letter typically includes information such as:
- Why significant weight loss is medically necessary
- The number of years you have been overweight (which should be five or more)
- Your weight (which should be at least 100 pounds higher than your ideal weight or a BMI more than 40 or 35 with medical problems)
- Obesity-related medical problems, such as sleep apnea, type 2 diabetes or hypertension
- An outline of your failed weight-loss attempts (number and types of attempts)
The more information you include about your failed weight-loss attempts -- on your own, through a commercial program or medically supervised -- and the more documentation and medical records you have supporting your situation, generally the greater the likelihood of being authorized for surgery. This type of information makes it clear to the insurance company that you have tried in earnest to lose weight, with no success. In short, you will need to help the insurance company understand that you have undertaken sincere weight-loss efforts in the past and that you need weight-loss surgery.
Malley Surgical can help you with your insurance authorization when you have your medical consultation.
What do I do if my insurance policy denies coverage for the LAP-BAND System?
If your request for authorization is denied by your insurance company, it may still be possible to get coverage. You will need to appeal the decision and address any specifics stated in the denial.
Alternately, you can choose to forgo the appeals process with your insurance company and pursue the LAP-BAND surgery immediately under our self-pay program.
Whether or not you have insurance, if you believe the LAP-BAND System is the right solution for your healthy weight loss, we encourage you to contact us to schedule your medical consultation.
Is financing available for my out-of-pocket costs?
For all our patients, Malley Surgical offers free referrals to financing companies and local banks that specialize in qualifying LAP-BAND patients for a variety of loans. Whether your financing needs range from your insurance deductible to the full cost of the surgery as a self-pay patient, you will receive:
- Free expert financing advice
- Diverse financing terms and options
- The ability to have surgery today and pay over time.
When you have your medical consultation, one of our financial counselors will meet with you to discuss our self-pay programs.
Click one of the options below to learn more:
SurgeryLoans.com offers the lowest and broadest interest rates assuring all patients the highest chance for loan approval. Additionally, we provide the most loan options available to assist your budget needs.
- Fixed interest rates starting as low as 5.9%
- Same as Cash Payment Plans for 6, 12 months
- Fixed low affordable monthly payments
- Loan Payment Plans up to $30,000
- Fixed Loan Terms up to 60 months
- No prepayment penalty
- Financing available for all Levels of Credit
- No Collateral or Down Payment Required
- All Co-signers are welcome
Get pre-approved now! No cost or obligation to apply!
Care Credit
One of the financing companies that we are currently referring patients to is Care Credit. They offer low monthly payments with 24, 36, 48, 60, or 80 month plans. There is also a three month zero interest plan available. We have seen great success in the number of patients they are approving. You can apply online at www.CareCredit.com, or call 1(800) 365-8295.
American Benefit Credit
We are pleased to offer American Benefit Finance as our lender. American Benefit Credit is a convenient, no initial payment, low monthly payment for amounts of $1,000 to $100,000+. Offering American Benefit Credit allows us to make the dream you’ve always wanted affordable.
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