The Winchester Medical Center Bariatric Program is excited to announce that beginning Monday, June 14th there will be NO SURGICAL PROGRAM FEE! We will still offer the same level of high quality education and services, but without the additional cost. If you are interested in learning more about our medical or surgical weight loss options, register today for a free information session.
Our office will contact your insurance provider to determine if you have bariatric surgery coverage*. We STRONGLY encourage you to also contact your insurance company and/or employer's human resources department to get this information as well as a copy of your policy. Please be aware that regardless of your policy, you will be responsible for all non-covered services.
As you are speaking with the insurance representative, be sure you make note of:
- The name of the representative you spoke with
- The time and date you spoke to the representative
- Their responses to your questions
Questions to ask your insurance company that may assist you in this process:
- Is bariatric surgery a covered benefit under my plan?
- Is Laparoscopic Roux-en-Y Gastric Bypass (CPT code 43644) a covered benefit under my policy?
- Is Laparoscopic Adjustable Band (CPT code 43770) a covered benefit under my policy?
- Is the Laparoscopic Gastric Sleeve (CPT code 43775) a covered benefit under my policy?
- Are Dr.Glembot and Dr.Wiedower IN-NETWORK or OUT-OF-NETWORK?
- If OUT-OF-NETWORK, am I still covered and what is my financial responsibility?
- What percentage of the surgery is covered by my plan?
- What is my yearly deductible? Have I met it?
- If I haven't met my deductible, how much more do I have to pay out of pocket before I meet it?
- What is my maximum out of pocket expense?
- What is my specialist co-pay?
- Is a referral required?
- Are there special requirements, such as a physician-supervised diet, mental health evaluation, weight history, etc. that must be completed before insurance will authorize my surgery?
- If yes, document what the requirements are so we can help you meet them.
Click here for a printable version of the questions above.
Insurance and Financing FAQ
Q. Which insurance providers consider the Bariatric Program as IN-NETWORK?
A. We are considered IN-NETWORK with the following providers, however you are encouraged to call your insurance provider and verify if your specific policy covers bariatric surgery. If your insurance is not listed below please contact the office to discuss your specific carrier with an insurance specialist.
Aetna
Anthem Health Keepers HMO, Medicaid
Blue Cross Blue Shield
Cigna
Community/Optima Health
Coventry/Southern Health
Medicaid
Medicare
Mamsi
Optima Health
PEIA
Tricare
Unicare/Healthlink/NCPPO
United Healthcare
4Most
Q. What if my insurance will not cover bariatric surgery?
A. We have self-pay packages available. Please contact our office for more information. In addition, we recommend that you contact your employer's human resources department. You can provide them with the medical conditions caused by obesity, the monthly cost associated with the medication required to treat the conditions and the amount of time off work needed to attend physician office visits to care for the conditions. This information will help your employer understand the benefits of covering surgery for future insurance policies, but may not affect your current policy.
Q. Are finance options available to help me with my medical expenses?
A. We accept Care Credit, which offers financing for medical purposes only. This can help you with cost of office visits, surgery, vitamins, supplements, etc. You will need to complete an application online (www.carecredit.com) or you can call 800.365.8295 to get started.
* Predetermination does not guarantee authorization or payment of surgery and is subject to exclusions and limitations.