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Will insurance cover the gastric band?

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The adjustable gastric band is one of several bariatric procedures that are considered safe and effective in many patients. The band has helped thousands of patients in California lose weight and maintain that weight loss. Additionally, many of these patients regain their health by finding relief from weight-related health conditions.

Because of the positive results seen with the band, many health plans and insurance companies include adjustable gastric bands as one of their weight loss benefits. This means that plans usually provide coverage for the majority, if not all of your LAP-BAND® and REALIZE® Band costs, including any band adjustments needed following the surgery. Because each insurance company has varying requirements for band qualification, West Medical offers a FREE Insurance Coverage Hotline to determine the coverage rate of your plan. For thorough help understanding your individual benefits when it comes to LAP-BAND® and REALIZE® Band costs, call us now at 800.561.9000 to have one of our insurance plan experts perform a verification of your benefits.

How do I get approved for coverage?

The majority of insurance companies will need your doctor to provide a letter of medical necessity for the gastric band procedure, and documentation that proves that you meet the criteria established by the National Institutes of Health. If your insurance company issues a “denial” for the gastric band procedure, this can be due to weight loss surgery not being one of the benefits provided, or an exception clause in your insurance plan. In a number of cases, we can work with your doctor or lawyer to get the denial reversed.

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What affects the cost of the procedure?

Every patient is different, as is the cost of the gastric band procedure. To understand the various factors that may affect the cost of the gastric band procedure, we've outlined some information to consider. The gastric band price quote should be heavily detailed and in writing to include all the expenses you might be billed for, including:

  • Pre-op tests and assessments
  • Surgeon fee
  • Hospital or surgery facility fee
  • Anesthesia fee
  • Adjustments and fills

What if I don’t have insurance coverage?

If you do not have an insurance policy, or if the gastric band cost is not covered by your insurance company, don't worry: there are still many other payment options available to you including cash discounts as well as REALIZE® Band and LAP-BAND® financing. To learn more about your options, give us a call at (855) 690-0565

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