Will medicare chunk a and b cover weightloss surgery?
i am an disabled 28 year old I'm morbidly obese, hyperlipedemia, hypertension,sleep apnea, avascular necrosis, acid reflux disease. i have medicare and molina, my pcp have written a medical necessity i have had my egd, and bloodwork done , tomorrow i go for a psychological evaluation and i enjoy 2 years of failed dieting and exercise my pcp feels that i could benefit from this surgery, i have already have a consultation with the weightloss dr. my question is can anyone out there that have experience or know if my insurance will approve me for the weightloss surgery. if not what are some of the things i can assist with in getting an approval
Answers:
I had a friend that had private insurance and they covered it, but I enjoy never heard of medicare covering it.
If it's causing health problems and the surgery is recommended by your doctor, some insurance companies will cover it. I don't know going on for Medicare though. You'll just have to call them and ask.
Most insurance companies are going to do everything within their power to keep from having to pay for a surgery that isn't critical, and most consider obesity to be a self-induced problem, not beyond the patient's control.
There are 5 makeshift 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 hold at least one co-morbidity related to obesity, and you must have be previously unsuccessful with medical treatment for obesity. In addition, these procedures are simply 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/mcd/search.asp?cl… If you contact these services they will help your further. Source(s): Independent Agent
Certified Senior Advisor(R)
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Answers:
I had a friend that had private insurance and they covered it, but I enjoy never heard of medicare covering it.
If it's causing health problems and the surgery is recommended by your doctor, some insurance companies will cover it. I don't know going on for Medicare though. You'll just have to call them and ask.
Most insurance companies are going to do everything within their power to keep from having to pay for a surgery that isn't critical, and most consider obesity to be a self-induced problem, not beyond the patient's control.
There are 5 makeshift 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 hold at least one co-morbidity related to obesity, and you must have be previously unsuccessful with medical treatment for obesity. In addition, these procedures are simply 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/mcd/search.asp?cl… If you contact these services they will help your further. Source(s): Independent Agent
Certified Senior Advisor(R)
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