Free Seminar Registration
If you are interested in learning more about Laparoscopic Gastric Bypass, Laparoscopic Gastric Banding – LapBand®, and Laparoscopic Gastric Sleeve procedures, we invite you to attend one of our complimentary informational seminars.



Limited Time Promotion
$11,999
Laparoscopic Gastric Sleeve or
Laparoscopic Gastric Banding
LAP-Band®
Self Pay Promotion
Find out more before this offer
ends!
Insurance

Insurance coverage of weight loss surgery is a controversial and difficult issue in the weight loss surgery industry. There are inconsistencies throughout the industry not only between different insurance companies, but also within the insurance companies themselves from state to state and from employer to employer. Insurance companies are constantly changing their coverage of the procedures from year to year. They often change what criteria they require the patients to meet.

It’s not surprising then that obtaining insurance coverage is one step in the weight loss surgery process that patients seem to dread the most. Insurance company personnel can be intimidating and confusing with their complex jargon, contradictory rules and strict guidelines. Our role as a program is to help you each step of the way through the insurance process. You and our insurance personnel work together as a TEAM to find out what coverage is available under your specific plan, what criteria needs to be met for prior approval, what records are needed from your medical doctors to help prove medical necessity, etc. Our goal is to help you move through the insurance approval process as quickly and painlessly as possible. This is not always a simple or easy process, but we’ve worked with many different insurance companies and that experience helps a lot. You will be helped though the insurance process by our two experienced insurance case managers assigned to you after your first consultation with the surgeon. You will know at your first consultation what benefits you may have and what are the insurance requirements.

 

Specific Insurance Plans

If you are calling to find out if we are in-network under your plan, be sure to ask using either KC Bariatric or Dr. Hoehn’s name. You should always check to see if the hospital is in-network as well. Again, Dr. Hoehn performs surgery at Shawnee Mission Medical Care in Shawnee Mission, Kansas; Shawnee Mission Outpatient Pavilion at Prairie Star; Heartland Spine and Specialty Hospital in Overland Park, Kansas.

Dr. Hoehn participates with many insurance plans, essentially too many to list, and the list is constantly changing! Below is a list of the most frequently seen plans, but remember that this list is NOT ALL INCLUSIVE and you should ASK your company if we are in-network under your plan if you don’t see your plan listed.

Insurance for Weight-Loss Surgery

One of the first steps you should take is to find out if you have coverage under your health care plan for weight loss surgery. You can find this out by contacting your benefits department with the number listed on your insurance card. Don’t be afraid to ask questions of your company representative – after all, this is your contract for health care benefits and you have the right to know what is available to you. Ask about coverage for weight loss surgery, specifying the surgery you desire (gastric bypass, gastric sleeve or LapBand gastric banding). You should also ask specifically if you have any exclusions to weight loss surgery on your plan. This can be a separate issue from coverage and an important one, particularly if you are a Blue Cross Blue Shield, Coventry or United Health Care** member. Be sure to write down exactly what information your representative gives you, and who you talked to in case there is a question later.

For all patients, while on the phone with your benefits representative, you should also review what benefits you have for inpatient surgery (Gastric Bypass or Gastric Sleeve) or outpatient surgery (LapBand) i.e. what annual deductible you have, what your maximum out-of-pocket is, etc. You will be expected to pay the usual co-pay amounts for office visits to our surgeons as specialists before your surgery. You should be aware of whether our surgeons or the hospital(s) are in- or out-of–network with your insurance plan as well. If you have any questions about whether our practice or the facilities are in-network or out-of-network under your plan, you should contact your insurance company or check your insurance handbook.

So, Now What?

Once you’ve determined that you’ve got coverage for weight loss surgery under your insurance plan, or you’ve worked out your financial arrangements, you’re ready to register for one of our upcoming free seminars.

  • Insurance Options
  • Insurance Alternatives
  • Self-Pay

Our insurance providers are constantly changing, and plans are being added and modified frequently by the insurance companies.

  • United Healthcare
  • Aetna
  • Blue Cross/Blue Shield : Federal, Local, In and Out of State
  • Humana - Choice Care only
  • Medicare, as non-contracted provider
  • Private Healthcare Systems
  • Cigna
  • AARP
  • Coventry
  • First Health
  • Freedom Network
  • Epoch
  • Great West
  • Multiplan
  • Sprint UHC and Aetna plans
  • Tricare Standard and Tricare for Life (Not Prime)
  • Wellmark
 

What if I Don’t Have Insurance Coverage?

The Bariatric Center of Kansas City does not directly provide a financing program through our office. We can provide you financing companies at your first visit. Other financing options to consider:
  • Self-Pay
Cash, personal or certified check are accepted.
  • Credit Card
We accept Visa, Mastercard, American Express and Discover.  
  • Outside Financing
Your personal bank, your mortgage company, and now even on-line internet financing companies can provide you with good alternatives to using your savings to finance your surgery. Many patients are able to plan ahead and use their “flexible spending plans” as part of their health care benefits to help with the cost of surgery. Don’t forget, too, that the cost of surgery may be tax-deductible for certain patients depending on their personal circumstances. The Bariatric Center of Kansas City does not directly provide a financing program through our office, but some of our patients have had good results using Capitol One’s on-line financing program at www.cosmeticfeeplan.com or call toll-free at 1-888-440-2375.

Private Financing

A significant number of our patients find that their insurance companies do not provide coverage for weight loss surgery and choose instead to privately finance their surgeries. We are always available to explain how the self-pay system works. Please contact our program coordinator to discuss your self pay options or discuss any questions you may have regarding specific charges and fees. Important for all patients: If your insurance company does not provide benefits to cover your initial weight loss surgery, whether due to exclusion or other determination, they will not provide benefits for any complications related to your surgery either. We perform weight loss surgery at Shawnee Mission Medical Center and Prairie Star Bariatric Hospital. Both facilities have special discounted fees arranged for self-pay patients called “global fees” in which most of the expenses related to your care for the surgery are consolidated. This global fee only covers the initial surgery and the standard care associated with that surgery. Each facility has their own policies regarding what is covered or not covered if the patient would suffer from any complications from their surgery. We are pleased to announce that due in part to our very low complication rates, the facilities’ policies of coverage for complications for self pay patients have recently become much more inclusive. Again, we have copies of hospital policies in our office for you to review should the private pay option interest you. We offer a program called BLIS insurance that will cover you for any post-operative hospital cost that may arise.

  • Medicare Patients
  • United HealthCare

Attention:

Medicare currently provides coverage for two forms of weight loss surgery that we offer: the LapBand Gastric Banding and the Laparoscopic Roux-en-Y Gastric Bypass surgeries. Medicare requires that all Medicare subscribers must have their surgeries performed by surgeons and at hospital programs that have been designated as ASBS Surgical Centers of Excellence.

Our surgeons are working with Medicare patients up to the age of 72 that we consider are good candidates for weight loss surgery. However, our surgeons are non-contracted Medicare provicers, which means that they will not be accepting Medicare assignment. If you have a secondary that covers weight loss surgery or Medigap plan, these may be helpful in covering the unassigned amount charged.

When you register for your informational seminar, we will send you detailed information about this, and will also discuss this at our insurance/financial session in the information session after the seminar.

It is important for Medicare subscribers to know that Shawnee Mission Medical Center is a Bariatric Surgery Center of Excellence and DOES accepts Medicare assignment.

Attention Subscribers:

Effective June 6, 2007 Shawnee Mission Medical Center signed a multi-year contract with United Healthcare Insurance. For patients with United Healthcare insurance, our surgeons are individually contracted with United Healthcare, and we currently perform the LapBand Gastric Banding, Laparoscopic Gastric Sleeve and the Laparoscopic Gastric Bypass surgery at Shawnee Mission Medical Center, Prairie Star Surgery Center and Heartland Spine and Specialty Hospital (HSSH) in Overland Park, Kansas. HSSH (located at I-435 and Nall) signed a contract with United Healthcare in March, 2007. Thus, we will be able to work with United Healthcare participants as in-network providers at an in-network facility. It is important for you to find out if you have coverage for weight loss surgery as well as a separate exclusion for weight loss surgery on your health care plan However, if you contact your company representatives by telephone you may not receive accurate information. Please find a written copy of your exclusions, either in a booklet or on-line and review the list for either “gastric bypass surgery” or “weight loss surgery.” If the exclusions list “weight loss programs,” then surgeries should be a covered benefit. Feel free to contact us to discuss at 913-677-6319 or fax us (913-677-1540) a copy of your exclusions to review.  

KCBC Blog
Free Seminar
  • 8/11/2014
    August Free Surgical Weight Loss Seminar
    6:30 PM
  • 8/25/2014
    August Free Surgical Weight Loss Seminar
    6:30 PM
  • 9/13/2014
    September Free Surgical Weight Loss Seminar
    1:30 PM