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Insurance & Prior Authorization

Insurance & Prior Authorization · Michigan

Insurance Accepted at
Michigan Weight Loss Institute

Led by Dr. Rita Kathawa, M.D. — Double Board-Certified Physician in Obesity Medicine & Internal Medicine

At Michigan Weight Loss Institute, obesity medicine is medical care. Many patients come to us with weight-related health conditions such as type 2 diabetes, hypertension, sleep apnea, or joint disease that may make their visits eligible for insurance coverage.

Led by Dr. Rita Kathawa, M.D., our team helps you understand what your plan may cover before you begin treatment. First, we review your benefits and referral requirements. Then, when appropriate, we handle prior authorization requests for medications and medication benefits so you can begin care with clearer expectations.

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What We Can Help With
  • Insurance plan review before scheduling
  • Referral guidance when required
  • Prior authorization documentation
  • Denial reviews and appeal support
  • Coordination with your primary care provider
  • Medication benefit verification
Insurance Verification Included Prior Authorization Support Sterling Heights & Bingham Farms
Cash Pay Options Available
Plans We Accept

Insurance Plans We Accept

Michigan Weight Loss Institute accepts the following insurance plans for eligible medical services. Please call our office to confirm your current benefits, referral requirements, and plan-specific coverage before your visit.

Medicaid Plans
  • Straight Medicaid
  • Meridian Health Plan of Michigan
  • Blue Cross Complete of Michigan
  • Molina Healthcare of Michigan
  • HAP Midwest Health Plan
  • United Healthcare Community Plan
  • Aetna Better Health of Michigan
Commercial, Medicare & Medicare Advantage
  • UnitedHealthcare
  • Blue Cross Blue Shield of Michigan (BCBSM)
  • Blue Care Network (BCN)
  • Priority Health & Priority Health Medicare
  • Wellcare Medicare
  • Medicare A/B
  • ASR
  • CIGNA
Blue Care Network patients: BCN plans may require a Global Referral before specialty care is covered. Please contact your primary care provider for a referral before scheduling.

Don’t see your insurance listed? Insurance participation changes periodically and some plans may not be shown on this page. Contact our office and we’ll be happy to verify your coverage and benefits. 📞

How It Works

The Prior Authorization Process, Step by Step

1
Medical Evaluation
Your provider reviews your health history, current weight, BMI, weight-related diagnoses, medications tried, and lifestyle history.
2
Insurance Review
Our team reviews what your plan may require — chart notes, diagnosis codes, lab results, medication history, and clinical criteria.
3
Submission
When clinically appropriate, we submit the prior authorization request with the documentation requested by your insurance plan.
4
Insurance Decision
Your insurance company reviews the request and issues an approval, denial, or request for more information. This typically takes 3–14 business days.
5
Next Steps
If approved, your care plan moves forward. If denied, we can review the denial and discuss whether additional documentation or an appeal is appropriate.
Be Prepared

What to Have Ready Before We Check Your Benefits

To help our team review your insurance and prior authorization options efficiently, please have the following ready when you contact us or come in for your appointment:

Your insurance card
Your photo ID
Your pharmacy benefit card, if separate
Your primary care provider name, if referral is required
A current medication list
Recent lab results, if available
Any prior authorization reference numbers from other providers
Your member ID number from your insurance card
Common Questions

Frequently Asked Questions

Does insurance cover medical weight loss visits?

Many insurance plans cover office visits for obesity medicine when there is a documented medical diagnosis such as obesity, type 2 diabetes, hypertension, or sleep apnea. Because each policy is different, coverage varies significantly by plan. Our team will verify your specific benefits before your first visit.

Does insurance cover Wegovy or Zepbound?

For example, some commercial insurance plans cover Wegovy and Zepbound for weight management with prior authorization. However, many plans still exclude these medications entirely. Medicaid coverage also varies by state and managed care plan. For Medicare patients, you can review Medicare GLP-1 bridge program eligibility to access Wegovy and Zepbound while national coverage expands. Then, we will check your specific plan and guide you through the process.

Do you guarantee prior authorization approval?

No. Prior authorization decisions are made by your insurance company, not by our office. Although approval is not guaranteed, we can help you compile the strongest possible documentation and submit the request correctly. When a request is denied, we can help you understand your options for appeal.

How long does prior authorization take?

Most insurance companies respond to prior authorization requests within 3 to 14 business days, though urgent requests may be processed faster. The timeline depends on your specific plan and whether additional documentation is required.

What if my medication is denied?

When your prior authorization is denied, we will review the denial letter with you and discuss whether an appeal is appropriate. In some cases, an alternative medication or additional documentation can support a successful appeal. Finally, we will explain all available options so you can make an informed decision.

Do I need a referral?

It depends on your insurance plan. In addition, some plans, particularly HMOs like Blue Care Network, require a referral from your primary care provider before seeing a specialist. Before your first visit, we recommend calling the member services number on the back of your insurance card to confirm your requirements.

Can you check my insurance before I schedule?

Yes. We can verify your insurance benefits before your first appointment. Please call our office or submit a consultation request online and our team will review your plan and let you know what to expect before you come in.
Insurance Participation & Coverage Disclaimer

Michigan Weight Loss Institute participates with many health insurance plans; however, participation, plan benefits, coverage requirements, and network inclusion may vary by specific policy, employer group, product type, and location.

The insurance plans listed on this website are provided as a general reference and may not reflect a complete or current list of all participating plans. Inclusion of a carrier on this website does not guarantee that your specific plan, network, benefits, services, medications, or treatment recommendations will be covered.

Patients are encouraged to contact our office and their insurance carrier directly to verify provider participation, eligibility, benefits, referral and prior authorization requirements, and coverage for specific services before scheduling or receiving treatment.

Coverage determinations are made solely by your insurance company. Patients remain responsible for any deductibles, copayments, coinsurance, non-covered services, or balances not paid by their carrier.

If you do not see your plan listed, please contact our office — we may participate with additional plans not currently reflected on this page, and our team will be happy to verify your coverage.

Ready to Check Your Insurance Coverage?

First, our team will verify your benefits and explain what your plan covers. Then, we will guide you through every step of the prior authorization process. Let us handle the paperwork so you can focus on your health.

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