Insurance/Finance Options

 

To determine if your insurance company will pay for your procedure, please call the member services telephone number located on you insurance card. They may ask for a CPT code to determine coverage and the codes are as follows:

43644 • Gastric Bypass
43770 • Gastric Banding (Lap-Band)
43775 • Gastric Sleeve

If your insurance company will cover your surgery, the following is a list of the requirements needed for authorization. This is a list of the most common plans. If your plan is not on this list you may contact your insurance company for a list of the requirements. If you need assistance please call our office at 904-389-8871.

Insurance Company Physician Supervised Diet Prior to Surgery Documented Weight History Letter of Medical Necessity from PCP Nutrition Evaluation Psychological Evaluation
Aetna 3 months 2 years Required Required Required
Avmed 6 months Not required Required Required Required
BCBS Federal 3 months 2 years Required Required Required
BCBS FL 6 months 5 years Required Required Required
BCBS SC 6 months Not required Required Required Required
Cigna 6 months 2 years Required Required Required
United Healthcare Not required for most UHC plans 5 years Required Required Required
Tricare Not required Not required Required Required Required

Self-pay Option:

If your insurance company does not cover the surgery then you have the option to be a self pay patient. We participate with Care Credit should you need a financing option.