Will my insurance pay for my surgery?
Many insurers in fact will cover your weight-loss surgery but it is difficult to achieve insurance authorization on your own. This is why we assign each patient a personal authorization specialist to stream-line this process. Insurance coverage varies from patient to patient and employer to employer. This is why its important to work with a specialist.

What insurances does Texas Bariatric Specialist accept?
We accept all insurances including Medicare. Both in- and out-of-network insurance plans are accepted. Please call us for details as all “in-network” provider lists are not always complete or up to date. We unfortunately do NOT accept Medicaid at this time.

What about cash pricing and options?
We are committed to helping as many patients as possible. We currently offer one of the lowest prices in the state (if not the lowest) for the gastric bypass and a very competitive lap band price. We work with each individual's budget and offer several financing plans including:

The cost of surgery can be tax deductible!!
It is true!! The IRS does allow the deduction of weight loss prgrams including surgery when medically necessary. Follow the this link for more information:

http://www.irs.gov/publications/p502/ar02.html#d0e2229 (click on weight loss programs) Note that the cost of surgery must exceed 7.5% of your adjusted income. Other costs delinieated by the IRS include wqeight-loss surgery prep programs, health insurance premiums, post-operative visits, smokeing cessation programs and other delineated costs may help you meet this requirement. Please consult with your accountant for further details.

Will Medicare pay for my operation?
Yes, Medicare will cover the procedure if it’s medically necessary. The definition of medical necessity is based on your Medicare administrator.  If you hold a red, white and blue Medicare card, the Texas administrator is Trailblazer.  They define medical necessity as a BMI > 35kg/m2 PLUS one of the following conditions:

1. Type II diabetes mellitus (by American Diabetes Association diagnostic criteria).
2. Refractory hypertension (defined as blood pressure of 140 mmHg systolic and/or 90 mmHg diastolic despite medical treatment with maximal doses of THREE antihypertensive medications).
3. Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of TWO lipid lowering medications).
4. Obesity-induced cardiomyopathy.
5. Clinically SIGNIFICANT obstructive sleep apnea (which has not been defined by Trailblazer).
6. Obesity-related hypoventilation.
7. Severe arthropathy of spine and/or weight-bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for the obesity).  You will need a letter from your spine or orthopedic surgeon attesting to this finding.
8. Hepatic steatosis (fatty liver) without evidence of active inflammation

These criteria are not in accordance with the national care determination.  We are adamantly against the local determination; however it is the dictating policy.  If you agree with our sentiment, we encourage you to contact your congressman.

For more information, please refer to:

http://www.trailblazerhealth.com/Policies/Local%20Coverage%20Determinations/Default.aspx?id=2807

If you meet these criteria, we offer perhaps the fastest approval process for Medicare in Texas. Patients who have a Medicare replacement plan may not need to adhere to these rules and should call their administrator for further details.  Please call us to see you can get started today.