On November 2nd, 2011 I had the gastric bypass surgery. I was 388 pounds+ and I've lost almost 200 pounds. I plan on losing 50 more pounds. I'm looking for a plastic surgeon or cosmetic surgeon who accept Medicare and Medicaid to pay for, at least partially, a tummy tuck and a breast reduction. I actually need more than a breast reduction, but I won't get into that here. I reside in the Tampa area:)
Post Bariatric Plastic Surgery Insurance Questions?
Doctor Answers (6)
Post Bariatric Plastic Surgery Insurance Questions
Congratulations on the weight loss to date. Insurance coverage for post weight loss procedures is rather sporadic and unpredictable. For Medicare and Medicaid the problem is compounded by the fact that you cannot find out in advance if you are covered. It is unlikely that you will find a surgeon, hospital or surgicenter willing to risk not getting reimbursement.
My suggestion would be to consult with the plastic surgery resident clinic at the University Medical Center, where the clinic has likely dealt with this issue before and may be able to help.
All the best
Medicare tummy tuck
The reality is that fewer and fewer surgeons will take medicare let alone medicaid.The new health care law will increase costs to a large extent and the providers who will accept an expanded medicaid patient base will decline.The cost of providing the service is GREATER than what the insurance will pay.You should call soem offices first to see who will take it.I think it is great you have lost so much weight Congratulations.
To the best of my knowledge, neither of these insurances will cover what you want done. And if they did, they pay so little, no one I know will accept payment from them for this work.
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Congratulations on your weight loss!!
That is a great accomplishment! It is frustrating to go through all of that and then not be able to have insurance help pay for it. In our practice, the surgery is rarely ever reimbursed by Medicare. It will almost never be paid for by Medicaid. As has been mentioned, there is no way to get preapproval. There may be a way to get your money refunded if a portion of the procedure gets ultimately paid by the company. Best of Luck!
Post Bariatric surgery questions
You may have a difficult time finding a surgeon to perform essentially cosmetic surgery under any insurance plan. The problem with medicare is that they will not approve anything in advance. Best to check with a local surgeon and get his opinion as to medical necessity.
Post bariatric insurance questions
Most insurance companies do not cover the post bariatric plastic surgery procedures unless there are medical reasons for the procedure. ie if your breasts are large enough for the insurance company to say you are large enough medically to benefit from it. for the abdomen usually they require failed treatment from rashs due to overhanging skin. It is a difficult position. We as surgeons feel they should cover it, but they do not agree. Good luck. I would see a surgeon soon, and plan for the future.
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