Can anyone tell me how I find out if Medicare covers weightloss surgeries recommended by a doctor?
My doctor recommended that I have a weight-loss surgery done. I am disabled and on medicare so she said to find out if Medicare covers it and then get back to her. How do I go about finding whether or not Medicare covers this type of thing? I’ve searched the websites and it is all very confusing to me. Please Help.
February 6th, 2011 at 5:36 pm
they don’t
February 6th, 2011 at 6:22 pm
You have to call a place that does the surgery and ask them. Some may take it due to health isssues with your organs.
February 6th, 2011 at 6:32 pm
They will but only if it’s serious enough, like getting close to getting a heart attack isn’t enough. Can’t believe how stingy they are. In Europe they help you, Watch “Sicko” great insight. I’m from Germany and there you get a Free Yearly Physical to make sure your ok. In England if your not well the doctor don’t get paid much.
February 6th, 2011 at 7:22 pm
medicare doesnt cover anything they dont explicitly have to. this includes “elective” surgeries. for example if you needed a heart transplant, which for some reason last time i checked was considered elective, you are out of luck. i think weightloss surgeries are under the same category. i may be wrong. i suggest you call medicare and get a person to talk to then ask them
February 6th, 2011 at 8:16 pm
There are 5 basic types of bariatric surgery. Medicare will not cover sleeve gastrectomy or vertical gastric banding. They will cover Roux-en-Y bypass (RYGBP), Biliopancreatic Diversion with Duodenal Switch (BPD/DS), and Laparoscopic Adjustable Gastric Banding (LAGB) under they following conditions: You must have a BMI of greater than 34, you must have at least one co-morbidity related to obesity, and you must have been previously unsuccessful with medical treatment for obesity. In addition, these procedures are only covered when performed at facilities that are certified by the American College of Surgeons as a Level 1 Bariatric Surgery Center or certified by the American Society for Bariatric Surgery as a Bariatric Surgery Center of Excellence.
You can find approved facilities on this website: http://www.cms.hhs.gov/center/coverage.asp If you contact these facilities they will help your further.