Trace W. Curry, M.D.

Insurance FAQ’s


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Will my insurance cover surgery?    This is an important issue that you will need to investigate.  It is entirely employer driven; in other words, the company you work for who provides the insurance decides whether or not you have surgical weight loss (Lap Band, Realize Band, gastric bypass, or sleeve gastrectomy) benefits.  You will need to call yourself to find this out, although there are many employers in Cincinnati, Northern Kentucky, and Ohio who we know definitely provide coverage.  We have an insurance team consisting of 3 full time professionals that have unsurpassed expertise to help you get your procedure approved!

What do I need to ask to determine if I have benefits?    You will need to call your benefit administrator (the number is usually listed on the back of your card) and ask them if you have surgical weight loss benefits.  Specifically, if you have coverage for laparoscopic gastric banding (Lap Band and Realize Band - CPT code 43770), laparoscopic gastric bypass (CPT code 43644), or laparoscopic sleeve gastrectomy (CPT code 43775).  If you call 1-866-SUCCESS they can also assist you with determining whether or not you have benefits for the REALIZE band.

I don't have surgical weight loss benefits but my family doctor said he would write me a letter and get it approved, will that work?    No.  This is one of the most frequent questions we get asked!  If you have a policy exclusion this means that your insurance will not cover surgical weight loss even if the president of the United States writes you a letter.  Your insurance company is not saying you don't need the operation, they are saying that your policy does not provide benefits to cover it, just as your fire insurance policy will not cover flood damage.

Is Dr. Curry in-network with my insurance?     We are in-network with most major insurers in Cincinnati, Northern Kentucky, and Ohio including Anthem, Blue Cross/Blue Shields, Wellpoint, Humana, Aetna, United, Healthspan, Cigna, and Medical Mutual (these may change from time-to-time, call the office for more up-to-date information).  For those in which we are not in-network, we have a Total Care Plan that includes free unlimited visits or adjustments for 2 years after surgery.  Come to one of our free information sessions or attend a webinar to find out more!

 

SPECIAL PLANS FOR GASTRIC BANDING!

Aetna -  Anthem - Blue Cross/Blue Shield - Humana - Wellpoint

JourneyLite, our outpatient gastric band surgery center in Cincinnati, is contracted with these companies and has a global rate that includes the surgeon's fee.  Therefore patients who go through our office with these plans and have surgery at JourneyLite do not have to pay any procedure fees to our office, yet still can take advantage of our Total Care Plan which includes 2 years of free band adjustments!! This is a fantastic opportunity--only one claim to your insurance company with your in-network deductible/co-pay. Save money and get better care!  

Do you accept Medicare or Medicaid?

Medicare has stringent guidelines on comorbidities that you must have to qualify for surgery.  In selected cases they will cover gastric band or bypass.  Bariatric surgery is a non-covered benefit for all Ohio Medicaid products that we have encountered.