Why Does Medicare Not Pay for (VSG) Vertical Sleeve Gastrectomy?

Morbidly Obese individuals are usually addicted to Food, have extensive health issues and are disabled (low income). Medicare will pay for mal-apsorption procedures making the morbidly obese patient looking for longevity and better quality of life, addicted to expensive Vitamins and Protein for life,or risk severe health issues. The VSG Procedure seems to limit the amount of food you can eat at each sitting without the mal-absorption problems. Why wont medicare cover this procedure?

Doctor Answers 3

Sleeve coverage for medicare

Medicare does cover gastric sleeve, but they leave the final decision to the "local contractor" who covers the region where you live. I practice in Louisiana and we have coverage for gastric sleeve as long as the patients meet the usual criteria for weight and related health conditions.


Lafayette Bariatric Surgeon

Not offered in all areas

Some of the government plans in some areas do not cover the sleeve as an option - it depends upon an area. While the agency has seen that this is effective for weight loss, and they approve in some circumstances - they do not approve with all circumstances. 

Terry Simpson, MD, FACS
Scottsdale Bariatric Surgeon
5.0 out of 5 stars 3 reviews

Medicare has agreed to cover the sleeve

After a very lengthy process, Medicare has finally agreed that Sleeve gastrectomy is an effective procedure and will be covered starting the end of January 2013. This is excellent news. There are some additional criteria to be followed for approval, but still is a move in the right direction.

Monali Misra, MD, FACS
Beverly Hills Bariatric Surgeon

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