Insurance Coverage

Patients often ask if their insurance will pay for weight loss surgery. The answer to this question varies; it is based on each individual’s insurance company and policy.

We recommend checking on your policy before your first visit so we can more accurately discuss your personal weight loss options.

Please note that there are specific health insurance guidelines that may determine coverage of services we offer. If you would like to confirm the eligibility of your plan, please contact us by phone at 808-691-7546 for a brief screening.

Questions To Ask Your Health Insurer

With our experience in comprehensive weight loss programs and weight management, we have found the following questions to be helpful in determining insurance coverage:

  1. What is the exclusion criteria for my plan with regards to weight loss surgery?
    Every insurer has exclusion criteria that explain what the company will or will not cover. For example, if a policy states that it excludes the surgical treatment of obesity, then it may not pay for a weight loss operation or any tests or clinical visits related to the surgery. 
  2. What portion of the hospital, surgeon and anesthesiologist’s bill will be covered?
    Some plans will cover 90% others 80%. With some plans, you may have a fixed deductible that you must pay each year.

  3. Are dietitian visits for pre- and post-op medical nutrition counseling covered in my plan?

  4. Is the cost of airfare related to clinic appointments covered?
    This is applicable if you are a neighbor island resident.

  5. Are there specific criteria I must meet prior to surgery?
    For example, some plans require that a patient sees a dietitian once a month for six consecutive months, or participate in a physician-directed exercise program for at least six months.


Useful Information When Speaking With Your Health Insurance Company

When speaking with a representative from your health insurance company, they may need something called a CPT code. The CPT code will depend on which surgical procedure you and your surgeon choose. The CPT codes for weight loss surgery are:

  • 43644 Laparoscopic Roux-en Y Gastric Bypass
  • 43770 Laparoscopic Placement of an Adjustable Gastric Band
  • 43775 Laparoscopic Sleeve Gastrectomy

Learn more about the different types of bariatric surgery offered at the Queen's Comprehensive Weight Management Program.

Register to Attend a Free Weight Loss Seminar

Before scheduling an appointment, register to attend a 60-minute free seminar. The session provides an overview of surgical and non-surgical weight loss options offered at CWMP and includes a segment with patients who share their personal experiences.

Free seminars are held monthly in Honolulu, West Oahu, Waimanalo, Kona, Hilo and in Molokai via teleconference. Physician referral not required for attendance.

Interested individuals can call 808-691-7546 or register online.