Will Medicaid/Medicare Cover the Removal of Excessive Stomach Skin?

Question

I had Gastric-Bypass surgery in September of 1989. Since approximently 8 months postop, I have had a very large area of excessive skin (Flab) on my lower abdomen. I suffer from lower back pain, an irratation under the flab. It is almost always a painful red, blistery, bloody, infected, ouzing of a yellowish discharge. It is very foul smelling, to the point that I am not able to be around other people, for fear of offending them with the smell.

Ashley B. Robey, MD · Answer

I'm sorry to hear about your challenges. Neither Medicare nor Medicaid will pre-authorize a procedure like a panniculectomy. You may be able to pay your surgeon and/or facility for your procedure and then potentially get reimbursed. I would not be overly optimistic about it, however. Best of luck.

Vincent N. Zubowicz, MD · Answer

Dealing with government medicine is difficult because they do not pre-certify a given operation. The surgeon has to perform the procedure and will find out in arrears if he has to be paid.

Jeffrey M. Hartog, DMD, MD · Answer

I would say it's quite doubtful. Removal of excess skin is mostly considered cosmetic and I'm not familiar with a surgeon who will take Medicaid for surgery.

Jourdan Gottlieb, MD · Answer

Since neither will "pre-authorize" one really cannot tell whether they will provide coverage for an individual. A denial can leave you with astromonical bills from a hospital.  Your bariatric surgeon can probably advise you best about coverage in your particular area, and about surgeons who might be providers. 

	
	All the best.

Will Medicaid/Medicare Cover the Removal of Excessive Stomach Skin?

Answers (4)