Question:
Medicare will pay for plastic surgery

But the surgeon wants me to pay up front then get reimburse when medicare approves it. It will cost 7,500.00 for the tummy tuck (which is covered they tell me) and 15,000.00 for the tuck and lift. Is this the norm. Can I seek another surgeon who will put in the paper with Medicare and wait for them to pay. Or will all surgeon want me to pay up front. There's no way I have that kind of money. Thanks.    — Rebe W. (posted on March 15, 2004)

March 15, 2004
Rebe, I am sorry I don't have an answer for you but I do have a question. I am looking into having a abdominoplasty done, and I have medicare too. How do we know for sure that medicare will cover it. I was told they would not because it was cosmetic. Can you give me any info on this please t/y Janice
   — betterfitness

March 15, 2004
Medicare will not pre-approve. I going through the same thing. My procedure costs approx, 1,200.oo and my surgeon wants 120.00. But right now I cannopt have tummy tuck I GAINED 20-30 pounds in 6 months. my surgeon wants me to weigh 250 or less I weigh now 290. E-mail me if you wish.
   — missturtle

March 16, 2004
I do not know the answer to this....but I want you to make sure what they are going to reimburse you after they get paid. Medicare will not pay the doctor $7500.00 for the tummy tuck. Will you just get the amount back that Medicare pays them? It will not be that much.
   — Mandybub

March 16, 2004
Saturday at the WLS meeting a plastic surgeon spoke to our group and he said medicare does not pay for tummy tuck, breast lift or body lift. They consider it cosmetic and whether you have skin hanging 6 inches down past your pubic area they will not pay. He has dealt with medicare on this many times and his patients end up paying and it is expensive. I know when I get to goal that I will need a tummy tuck and bat wings removed and inner thigh lifts, but there is no way I can afford it. I have medicare. Usually they would pay if the doctor said it was medically necessary, but this is something they consider not medically necessary I guess. On a breast lift they will pay if there is tissue to be removed, but not if skin is to be removed and breast lifted. I do not have medicaid but they will not pay either. Irish Fowler
   — mspisces

March 16, 2004
I have medicare...I am just starting to look into getting some reconstructive surgery.....medicare does cover it if it is medically necessary, as I called medicare and asked. Seems the problem is in finding a plastic surgeon who doesn't require anything up front though.
   — jennifer A.

March 20, 2004
My father had Medicare pay for it and he didn't have to pay anything up front...I would check out other doctors.
   — Beffy W.

March 20, 2004
I just had my tummy tuck and breast lift done on March 15th and I didnt have to pay anything up front with medicare. I dont think you should pay anything up front. I even checked with my friend that is a medical biller and she said "No the patient shouldnt pay anything up front for Medicare doesnt require approval and as long as medically needed they pay". I hope that helps ya. All I can say is that I am so happy to have it all done now. Take care and I wish you the best of luck
   — Holly B.

March 20, 2004
I am really interested in the replies to this question, too. I am on Medicare, and I already need a TT and breast lift and brachioplasty. I went to the Medicare site and all I could find is that plastic surgeries will be paid for if they are reconstructive, not cosmetic. Before my gastric by-pass, I could have used a breast reduction. Now, my weight loss has reduced them for me *G* What I want the very most is the brachioplasty. My bat wings are larger than my actual arms. Both my arms ache, and I think it's because of this excess flopping around. Proving that to anyone may be an entirely different story. <br> I hope everyone who has any information about Medicare will post and help the rest of us understand where we stand!<br> Linda Lap RNY 6/11/03 301/191/150
   — Linda S.