Getting Started

How to get started

Our program offers two paths — medical weight loss and surgical weight loss — and the steps to get started are different for each. Medical weight loss usually begins with a single consultation. Surgical weight loss follows a more structured process that includes our required educational seminar, followed by insurance verification, an evaluation and pre-surgery visits. Review the path that fits your goals below, or contact us and we’ll help you find the best starting point.

Medical Weight Loss

Medical weight loss is an option for patients who want to manage their weight with provider support — including nutrition counseling, behavioral support and prescription weight loss medications (such as GLP-1 medications) when medically appropriate — without surgery. Getting started is simpler than the surgical process. Contact us to schedule an initial consultation.

Your first visit is a one-on-one consultation with one of our providers, who will:

  • Review your medical history, current medications and weight history.
  • Complete an initial history and physical, and order baseline lab work if needed.
  • Talk through your goals and build a personalized plan, with regular follow-up visits to track your progress and adjust your plan over time.

You can learn more about the program and your options on our Medical Weight Loss page.

The required educational seminar and the pre-surgery evaluation steps are not needed to begin medical weight loss. If surgery becomes the right option for you later, your care team can help you transition to the surgical process below.

Surgical Weight Loss

Information Seminar

Conemaugh Health System offers an information seminar either online or in-person. This is to educate individuals on necessary information regarding types of weight loss surgery, criteria for surgery, guidelines for pre-surgery and post-surgery, and lifestyle changes necessary for long-term success. Please register for our Free Educational Seminar via the form here. Once we have reviewed your information and are able to verify your insurance, a team member will contact you to set up an appointment for an evaluation and your schedule your educational seminar. You will be required to complete this seminar, either in-person at our weight loss clinic, or online, to proceed to the next step.

Visits

Prior to surgery you will meet monthly with our nurse practitioner to review labs and testing and to access your progress.

Insurance Verification

Insurance providers and individual plans vary in coverage for weight loss surgery and related services. Each patient is responsible for insurance co-pays and deductibles at the time service is rendered. Our team will work with each patient to verify bariatric surgery coverage. We encourage each patient to also call their own insurance to verify their coverage and financial responsibilities.

WPBI has partnered with Clear Health to offer personalized pricing to patients with an out-of-pocket responsibility. Contact our office directly to learn more.

Surgical Weight Loss Insurance FAQs

Most insurance plans consider your BMI along with other underlying medical conditions you may have. You may qualify if you have a:

  • BMI of 30–34.9 with Type 2 Diabetes
  • BMI of 35–54.9 with or without a serious health condition
  • BMI of 55 or greater
How do I find out if my insurance covers weight loss surgery?

For commercial insurance policies, contact the customer service number on the back of your insurance card and ask this question exactly: “In my certificate of coverage are there benefits for weight loss surgery for morbid obesity if medically necessary?”

For Medicare and Medicaid, there are benefits for weight loss surgery as long as the criteria is met. There is no need to contact Medicare and Medicaid.

What does the insurance-required diet involve, and how long is it?

Usually the diet must be for at least 6 full months, which is one initial visit and 6 follow-up visits. Your appointments must be consecutive and the diet must be successful, meaning your end weight must be the same or less than your start weight.

If I have co-morbid conditions, do I still have to do the diet?

Most insurance companies that require a diet still require the diet no matter how many co-morbid diagnoses you have.

What if my insurance says there is an exclusion in my policy?

This means that your particular plan does not have benefits for weight loss surgery, no matter if you meet the medical necessity requirements or not. Your insurance may tell you that you have appeal rights. Keep in mind that you will be appealing policy and not medical necessity. If there are no benefits for weight loss surgery, it basically means that the benefit was not purchased by your company.

If my insurance will not pay for the surgery, can I pay for the surgery myself?

We do offer bariatric surgery for patients who would like to pay out-of-pocket. Please contact us directly for a quote.

My insurance question wasn't addressed here. Who can I contact?
Please send an email to mbrubaker@conemaugh.org.

Medical Weight Loss Insurance FAQs

Does insurance cover weight loss medications like GLP-1s?

Coverage varies by plan and is changing quickly. Our team will verify your benefits before prescribing, and we'll talk through your options if a medication isn't covered.

How long does medical weight loss take?

There's no set length — medical weight loss is an ongoing, individualized program, and your provider will adjust your plan based on your progress. (Note: The 6-month diet referenced in the surgical FAQs is an insurance prerequisite for surgery, not a medical weight loss rule).

Can I start with medical weight loss and consider surgery later?

Yes. Many patients begin with medical weight loss, and your care team can help you transition to the surgical process if that becomes the right choice.