Submitting ORBERA gastric balloon into insurance in order to meet deductible?

Question

Can a patient request that the orbera balloon procedure be submitted to their insurance in order to meet their insurance deductible for the year since we know it's not covered. Since Obesity is categorized as a medical condition I'm wondering if this is a possibility especially if the insurance does cover bariatric services. Thank you.

Christopher E. McGowan, MD · Answer

Because insurance plans do not cover the Orbera procedure, you are not likely to be successful in submitting a claim for reimbursement. You can certainly use your Health Savings Account (HSA) toward the procedure, but there isn't a current mechanism to apply the cost toward your deductible. There are multiple financing options available to help pay for the procedure.

Isaac Raijman, MD · Answer

Insurances do not cover it. You may contact them and see if you are successful in losing weight if they pay for it. You may be able to use your health savings account. Best of luck

Angelo G. Coppola Jr., MD · Answer

One of the biggest questions that I am asked by patients seeking a gastric balloon is insurance coverage. We have found that some  plans will allow payment using a health savings account. Others will reimburse the patient after they have lost a sufficient amount of weight. The vast majority of plans, however, have no coverage whatsoever. 
You would need to check with your insurance plan to see if this would be considered a covered service or if they would allow it to go toward your deductible.

Submitting ORBERA gastric balloon into insurance in order to meet deductible?

Answers (3)