Insurance

Here at Lifetime Weight Loss Surgery,
we strive to provide our patients with the best care in a safe, comfortable, friendly atmosphere. Our surgeons, in particular, are delicated to giving each patient the professional surgical expertise and care they deserve.

We accept all types of insurance, including PPOs, HMOs, Premier Care, PMG, and SCFHP, as well as State and Federal Health Coverage Plans, including Medicare and Medical. Our office is here to help you with any questions regarding insurance matters. You are always notified before your surgery as to whether your insurance coverage requires a deductible, co-pay, or patient’s portion, or whether they provide full coverage for the specific procedure you need.

Regretfully, we cannot inform you of any facility fees, or any additional fees, that may incur at the hospital, including fees related to anesthesiology, pathology should a biopsy be taken, etc. We encourage you to discuss these matters directly with your insurance provider or with the facility where surgery will be performed.

Also if you do not have insurance, we will gladly accept cash or checks.

What is the difference between an HMO and PPO?

(HMO) Health Maintenance Organization A health care payment and delivery system involving networks of doctors and healthcare institutions. It offers consumers a comprehensive range of benefits at one annual fee (often with co- payments or deductibles that vary from service to service) but they can see only providers in the network. Physicians and other health professionals often are on salary or contract with the HMO to provide services. Patients are assigned to a primary care doctor or nurse as a “gatekeeper” who decides what health services are needed and when. For now, for HMO members, we only contracted with PHYSICIANS MEDICAL GROUP of SAN JOSE.

(PPO) Preferred Provider Organization. A network of medical care providers that provides various medical care services to covered employees and retirees for specified fees. Although fees charged by PPO providers are usually less than those charged by non-PPO providers, the employee may seek treatment from any provider. We contract with most of PPO plans

HMO Insurance

Below is a list of the most common types of HMOs we accept. If you do not see your HMO listed, please contact us so that we can work with your insurance company. If you do not have insurance, we will gladly accept cash or checks.

-(HMO) Health Maintenance Organizations:

-Physicians Medical Group of San Jose (both insurance and medical)

-Santa Clara Family Health Plan (Medical)

-Blue Cross Medical of California (Medical)

-Premier Care (Medical)

Please do not hesitate to contact Lifetime for any questions regarding insurance.

Tips on Dealing with your Doctor

Many HMOs require you to choose a primary care physician. That doctor will be your main contact with the HMO when it comes to medical matters. Make sure you find one you will get along with. Sometimes you will simply pick a name off a list, or the HMO will assign a primary care physician to you. Get to know that doctor over a couple of visits. If you like him or her, fine. If you don’t, talk to people who are in the same HMO, or the same medical group as you to see if they can recommend a doctor they might know about. See if someone at the HMO or medical group can suggest someone.

Be respectful of your doctor’s time. Health plan doctors work under time pressure since they have many patients to see, and want to give each of them the best care possible.

When visiting your doctor, always make sure you are ready to use your time wisely. Have your concerns written down. What are your symptoms, what are your worries, what are your expectations? Ask all the questions that are important to you, and be honest and open with your doctor if he or she has questions for you. Don’t be rushed if there’s something that is on your mind that you haven’t gotten to.

If you think you need to see a specialist, you will have to discuss this with your primary care physician. Most HMOs require the primary care physician to approve appointments with specialists.

If you are not sure your doctor is right about a diagnosis or course of treatment, especially if it involves a major procedure like surgery, you have the right to see another doctor for a second opinion. In many cases, the HMO will pay for this. A second opinion might confirm what your first doctor said, but in some cases the second doctor sees something the first doctor missed, or knows something the first doctor doesn’t.

If your health plan does not allow you to get a second opinion, ask for an explanation and ask them to put it in writing.

Once again, be familiar with your plan’s grievance process. If you do not agree with any medical decision, the plan’s grievance process is designed as the first step in resolving the problem.

PPO Insurance

Below is a list of most PPO insurance plans we accept. If you do not see your plan listed, please contact us so that we can work with your insurance company. If you do not have insurance, we will gladly accept cash or checks.

(PPO) Preferred Provider Organizations:

-Aetna-Alliance PPO-Benesight-Blue Cross-Blue Cross-Blue Shield-Blue Shield-Cigna-CCN-CommonWealth-First Choice Health Net Work -HealthNet-Great-West-One Health Plan-Pacificare-Preferred Care Partner-PreferredOne-Trust-life Insurance-Secure Horizons-United HealthCare

Please do not hesitate to contact Lifetime for any questions regarding insurance.