Before The Surgery Back Insurance Carriers The surgeons of the Obesity Surgery Center of Louisiana accept ALL types of insurance. Approval by your insurance company is based on MEDICAL NECESSITY. This term means that you can show that is it medically necessary for you to have this type of procedure in order to improve your health. To be medically necessary, all other weight loss attempts must have been exhausted with no lasting and significant results. Basics for approval of bariatric surgery by any carrier include: Letter of support from your family physician as well as any physician treating you for obesity related health conditions (Cardiologist, Pulmonologist, Orthopedic, etc). Chart notes indicating morbid obesity and health conditions / medications. Chart notes indicating weight loss attempts that were supervised by your physician. AETNA: 5 years of chart notes documenting weight; Chart notes of a physician who has supervised you on at least one attempt to lose weight including medication or exercise or simply giving you a diet plan to follow; letter of recommendation from your physician as well as the bariatric surgeon. Referral by your primary care physician is necessary for all AETNA HMO's. Please secure this referral prior to your first office visit. BCBS: This plan is very specific. Each policy is individual and some will EXCLUDE WEIGHT LOSS SURGERY! Please check with your company by calling the number on the back of the card. If it is not exclude, they will tell you that it is based on medical necessity. Medical necessity is based upon your chart notes from your physicians. Please gather as much as possible. CIGNA: Very difficult to obtain approval. They require at least two diet attempts in the past year, supervised by your doctor and the diets must have been at least 26 weeks (6 months) in duration with weight checks by your doctor monthly. This must be documented in chart notes and a letter from your doctor stating this is not sufficient! AMERICAN LIFECARE: (Including all insurance companies which are subsidiaries of American Lifecare - check the back of your card for the American Lifecare emblem) This company is very supportive of treatment for obesity. They do require the basics as described above. TRICARE: Government and Military employees and their dependents are insured by TRICARE/CHAMPUS. This company also requires the basics as described above. Your primary care physician MUST MAKE A REFERRAL to the surgeon of your choice. It is mandatory before visiting for your first office evaluation. UNITED HEALTHCARE: This company is supportive, but precertification may take from 2-6 weeks and documentation must be complete, neat and orderly. Please gather all your basic information prior to visiting the office. OCHSNER: Ochsner does approve of this surgery in most cases, however a Psychological and Dietary evaluation are necessary prior to approval. We can set you up with a Psychiatric consult in the Lake Charles area or you can make an appointment with a Psychologist on your plan in your area. OFFICE OF GROUP BENEFITS (OGB): State employees have this coverage. OGB will not cover this surgery under ANY CIRCUMSTANCES. PHCS: This company adheres to specific guidelines as defined in the basic necessary documentation above. Many other carriers accepted. If you do not see your carrier listed here, please call our office to find out if your carrier covers this surgery or call the number listed on the back of your insurance card.