 America is facing a rampant increase in the problems of obesity, and more and more people are being put in a position wherein they have to seek medical treatment for their weight gain. Weight loss surgeries have come a long way since they were first introduced, and today, patients have access to a wide range of options that can help them get the body that they want.
Because of the potential risks that one faces when entering the category of obesity, the medical industry identifies this as an incredibly severe condition, which is why doctors are quick to recommend some remedial measures to take care of the problem that one might be facing as a result of excess weight. However, not all insurance companies share this common opinion about weight loss surgeries, and sometimes they tend to impose harsher restrictions on the coverage that one can get for weight loss surgeries under their plans. Getting Health Insurance Gaining good health insurance is an absolute necessity in today's world because of the ever-growing cost of health care in the country. Prices for checkups, medications, and more are skyrocketing. People are consistently put into a position wherein they have to rely on their health insurance provider to be able to cover the costs of any treatment or surgery that they would need. For life-saving treatments, in particular, having health insurance can be the difference between someone getting the care that they need and someone not being able to afford the cost of the treatment. Weight Loss Procedures Commonly Covered By Health Insurance When it comes to weight loss procedures, there are four main kinds that health insurance providers are ready to provide coverage for. These include the Sleeve Gastrectomy, Gastric Bypass, Duodenal Switch, and Lap-Band. Usually doctors will recommend one of these four options for a patient to go in for, depending on their individual needs. However, there are certain instances in which other procedures may be offered, which is mainly in severe cases. In these instances, the health insurance company is the one who can decide whether or not they should provide the insurance. Coverage Based On Type Of Insurance In America, the coverage of a weight loss surgery is mainly dependent on the company that you are getting the insurance from, and the kind of health insurance that you are opting to go in for. There are a number of plans that are usually offered to customers, and it is essential to know what these plans entail. Family Insurance Under the Affordable Care Act, insurance companies in twenty-three states in the United States are required to pay for the patient's weight loss surgery as part of the insurance coverage that they have opted to go in for. As a result, a person who is in possession of some individual or family insurance can go in for the weight loss surgery without having to worry about the expenses not being covered by their provider. Typically, when one is trying to get weight loss surgery, the hospital or clinic is the one who will contact the insurance company about the procedure recommended by your doctor, and after that, they let you know if your operation is covered by insurance. You can also contact the insurance company themselves to know whether or not the plan that you have is covering weight loss surgeries. Employer-Funded Insurance If the company that you are working with offers you some kind of health coverage, and you are within the twenty-three states, there is a high chance that you will be given the coverage for the surgery that you want to go in for. The process for this is similar to what we mentioned for family insurance, which is that either the clinic will contact your insurance provider, or you can do so yourself. When it comes to employer-provided insurance, however, certain professional institutions may have additional restrictions when it comes to the kind of policy they offer. One of the best ways to be sure of this is to contact an HR personnel within the company that you are working with to understand whether or not you can get the surgery that you need. Smaller companies are less likely to cover weight loss surgeries as compared to larger companies, which is also something that must be taken into consideration when relying on the insurance offered by your workplace. References: https://www.fairhealthconsumer.org/insurance-basics/healthcare http://www.baybariatrics.com/procedures/sleeve-gastrectomy https://www.horizonblue.com/providers/news/news-legal-notices/prior-authorization-procedure-search-tool-available
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 With regards to insurance coverage for cosmetic procedures, there is good news as well as bad news. The bad news is that it is impossible for insurance to cover purely cosmetic procedures. However, if the cosmetic procedure is medically necessary, it may be covered by insurance even if it will also improve your appearance. And that’s the good news.
A Medical Nose Job Can Be Covered Certain medical nose procedures are typically covered by most healthcare plans. These medical jobs can also be called septoplasty or a deviated septum procedure. But if it’s rhinoplasty, that is for purely aesthetic reason, and it will not be covered. You are advised to work with an ENT who will help to justify that you need your nose reconstruction job to correct your breathing problems. Many patients with nose problems usually choose to undergo septoplasty combined with rhinoplasty at the same time to improve the appearance of their noses. The insurance will most likely cover the necessary septoplasty procedure, but you may be required to pay for the rhinoplasty. Orthodontic Procedures Can Be Covered There are dental insurance plans that cover certain orthodontic or dental procedures. But various factors affect the actual cost of orthodontic procedures such if you have or don’t have dental insurance and the recommended dental treatments or procedures. It will depend on your dental insurance plan as to how much discount you will get for the cost of undergoing dental. If you're wondering on the teeth straightening front, braces and plastic teeth aligners can also be paid for. You may consider the following tips if you want to save money on dental procedures:
Some Botox Procedures Can Be Covered If your Botox procedure is purely for aesthetic improvement, it will not be covered by insurance. However, if the botox procedure is functional or medically necessary, the insurance company will shoulder part of or perhaps even all of the expenses. The procedure should be considered as reconstructive and that your medical condition is considerably interfering with your quality of life. These medical conditions could include migraine headaches, facial and eyelid spasms and hyperhidrosis or excessive sweating. Always remember to ask your doctor plenty of questions regarding the resources available for these, as they could have some financial resources available.  If you are scheduled for an upcoming surgery, it is only natural to have doubts and concerns. These feelings are normal, even for minor, minimally invasive surgeries. One of the best ways to alleviate anxiety about medical procedures is to ask plenty of questions before you enter the operating theater.  The Basics First of all, you should ask about the basics of the procedure. Your doctor should be willing to walk you through the process so that you know what to expect, from the moment you enter the hospital until you are discharged. If you are unclear on any aspect of the procedure, do not be afraid to follow up. This is about your health and life, and you are your own best advocate. You should also make sure that your insurance company is on board with this procedure so you aren’t left holding a huge bill at the end of the day. Inpatient or Outpatient You should also ask how long you will be in the treatment facility. Knowing this can help you plan what to bring, and can also help you navigate your insurance company's rules for inpatient versus outpatient procedures. If you will be in the hospital for several days, it is a good idea to bring some entertainment items, and arrange for visitors. Hospital food is notoriously unappetizing, so you might want to ask your care team if you will be allowed to bring in an outside snack or two.  Rules For Visitors Some people feel much more comfortable if a loved one can be present during the procedure. This is not always possible, depending on the type of surgery. Knowing in advance whether you can have a support person in the operating room with you can help you better prepare. What To Expect During Recovery Sometimes physicians are so focused on the details of the surgery itself that they fail to give you an adequate understanding of what the recovery period will entail. Ask as many questions about recovery as you do about the procedure. Find out how long you will be on bedrest or have limited mobility. Also, ask what options will be available to treat residual pain. Doctors often prescribe opioid medications as a post-surgery pain treatment, but these medications are highly addictive. If this is a risk you'd like to avoid, ask your doctor about alternatives.  What Resources Are Available
If your procedure will be performed at a large medical complex, contact the surgical center and find out what resources will be available for you. You might have access to recovery and support groups, outside funding, or other community resources. Knowing what tools you have at your disposal can make the recovery process a little easier. With research and communication, you will be an informed patient, ready for a successful and life-improving procedure. Your research should focus on all aspects, including how this will work with your insurance, what you need to do to prepare, and what you will need after your surgery. Resources: |
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