Plastics and medicare
Yes, Medicare will cover some plastic surgery. What I know about the subject is first stay away from the term plastic surgery and use the term reconstructive surgery and medical necessity. Medicare technically does not cover plastic or cosmetic surgeries so if you call a doctor stating you want to know if he will file a medical claim for plastic or cosmetic surgery the answer will be no. The process, once you find a surgeon that accepts Medicare is no different then if a person was filing a claim under any other insurance. I think the biggest challenge will be finding a plastic surgeon that will even process an insurance claim.
The process is worth the research stay encouraged Are any procedures ever covered by insurance?
A: Breast reduction and panniculectomy, following gastric bypass and weight loss, are two procedures which are sometimes covered by insurance. If a patient’s physical condition meets certain criteria, the surgeon will send a dictated request for consideration and a photo of the area in question, to the Utilization Review Committee of your insurer, who will either approve or deny payment. A Committee’s review and decision normally requires 6-8 weeks.
The procedures most noted to be covered by insurance even medicare are listed above but their are others even thigh lifts if it is causing you problems, the problem is the most plastic surgeons are looking for cash pay outs and dont really have knoweldge of what your insurance will cover and the process. What I did is have the panniculectomy, the plastic surgeons website said he accepted insurance my thing was that like this web site has stated you have to have went to x amount of doctors for x amount of months. My insurance clearly stated that all that was not even needed the only thing I need as to my personal insurance policy coverage was for the plastic surgeon to see a medical need. I did all my own policy research and kinda felt I had forced it on them because they just had the same general knowledge of the process as with on the site. I got a letter from my insurance stating they would pay for the procedure and the doctors offices in days of calling in the request and it did not even take 6 weeks. I wanted my thighs done but the doctors office was sure that most insurance companies will reject the claim after the surgery stiffing them, while cash pay is cash pay so basicly.
A: Breast reduction and panniculectomy, following gastric bypass and weight loss, are two procedures which are sometimes covered by insurance. If a patient’s physical condition meets certain criteria, the surgeon will send a dictated request for consideration and a photo of the area in question, to the Utilization Review Committee of your insurer, who will either approve or deny payment. A Committee’s review and decision normally requires 6-8 weeks.
The procedures most noted to be covered by insurance even medicare are listed above but their are others even thigh lifts if it is causing you problems, the problem is the most plastic surgeons are looking for cash pay outs and dont really have knoweldge of what your insurance will cover and the process. What I did is have the panniculectomy, the plastic surgeons website said he accepted insurance my thing was that like this web site has stated you have to have went to x amount of doctors for x amount of months. My insurance clearly stated that all that was not even needed the only thing I need as to my personal insurance policy coverage was for the plastic surgeon to see a medical need. I did all my own policy research and kinda felt I had forced it on them because they just had the same general knowledge of the process as with on the site. I got a letter from my insurance stating they would pay for the procedure and the doctors offices in days of calling in the request and it did not even take 6 weeks. I wanted my thighs done but the doctors office was sure that most insurance companies will reject the claim after the surgery stiffing them, while cash pay is cash pay so basicly.
Most Active
Recent Topics
