We understand the insurance approval process can be a challenging experience. One key focus of the TriStar Horizon Experience is to provide you with assistance needed to successfully navigate the approval process.
Our surgeons and medical center are in-network providers for most insurance plans. Insurance benefits and criteria for weight loss surgery can vary greatly by plan and by employer. We will verify benefits and criteria specific to your plan. Most insurance companies base their criteria on the NIH guidelines:
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BMI of 40 or greater
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BMI of 35-40 with significant co-morbidity
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Documented dietary attempts ineffective
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Multi-disciplinary team approach
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Life-long medical surveillance
These requirements only apply if surgery is a covered benefit under your policy. Some policies have exclusions which means your insurance plan does not cover these services. This list is subject to change without notice from your insurance company.
The cost of band adjustments (frequently referred to as “fills”) is not included. The cost for adjustments is $250.00. You can anticipate the need for approximately four adjustments in the first year after surgery.
Most importantly, our self pay rates include unlimited access to our registered dietitians, exercise physiologist, support groups and our Psychological Support Program. Some patients choose to borrow against their 401K plans or to utilize home equity loans. If you need assistance with financing your surgery, we work with several healthcare finance companies.
Financing is available through:
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Chase Health Advance -- Call 1-877-280-2547
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Surgery loans -- Call 1-888-502-8020 or apply online www.surgeryloans.com
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LAP-BAND -- Call 1-866-LAP-BAND (527-2263)
Insurance List
Solutions Surgical Weight Loss Center, a department of Horizon Medical Center, accepts most commercial insurances. We will be happy to contact your insurance company to determine if bariatric surgery is a covered benefit under your insurance plan. Please contact us at 615-326-2502 for any questions regarding insurance coverage.