Posted on 09/23/2015 at 10:10 AM by Iowa Weight Loss Specialists
If you’re overweight or obese, anytime is a good time to have weight loss surgery for the health and wellness benefits, but end-of-the-year has some additional insurance benefits to consider.
Depending on your medical history, you’ve probably made a pretty good dent or even met your annual deductible. If you have already met your deductible, the cost (depending on what your insurance covers) will be significantly less than if you haven’t yet had any medical expenses, which reset at the beginning of the year. If you have a diagnosed health condition, such as obesity, hypertension, sleep apnea, or others, you can benefit both physically and financially from having weight loss surgery before the end of the year.
Here’s an example:
You want to have weight loss surgery this year. You have an annual deductible of $1,500. Your co-insurance on surgeries and hospital stays is 40% and your out-of-pocket maximum is $6,000.
You have already used $5,500 of your out-of-pocket maximum to-date. If you had weight loss surgery in 2015, you would only pay $500.*
If you were to wait until the New Year, you would need to first meet your $1,500, plus your co-insurance amount, making it much more expensive.
So would you rather have the cost of your surgery mostly covered now or have it cost significantly more at the beginning of the year?
In addition, if you participate in flex spending or FSA Contributions, you can use those pre-tax funds for certain medical costs if you have been diagnosed by your physician with health concerns, such as hypertension, obesity, and others. This could include co-pays, prescription refills, and in some cases, blood work and other tests your doctor might want you to have done. While these funds would not work towards surgery itself (except any co-pays and pre-surgical needs), they would be beneficial for patients in our non-surgical Medical Weight Loss program. This program focuses on diet, exercise and if necessary, some medications. We also may have blood work completed to see if you have any barriers to weight loss.
These FSA funds are “use or lose” funds, so you want to make sure to use as much of these by year-end as you can.
Now’s the time to check with your insurer to see what benefits you’ve used and what you have available for the remainder of the year. Make sure to take advantage of any savings before January 1!
At Iowa Weight Loss Specialists, we also understand the timeliness of having surgery by the end of the year for the insurance savings. We work diligently with your insurance provider to get you ready and scheduled in a timely manner. No long waiting lists or re-schedules. We want to see you on your way to a healthier lifestyle as soon as you’re ready!
Additional questions? Attend one of our free informational classes to learn more about our programs and have all your insurance and weight-loss questions answered!
* Please note that each insurance plan differs and weight loss programs may or may not be covered depending on your specific coverage. Check with your insurance provider on any exclusions in your plan.