Question:
Can or WILL Medicare pay for excess skin removal???? in TX

I noticed the "shriner's Burn Unit" advice comment; However, when I called them, they were VERY adamant that one must be deceased in order to donate excess skin.... I feel so hopeless at this point..........what can I do? where do I turn? Have soooo much skin and still feel sooo disabled... pls help!!    — Teresa S. (posted on January 19, 2006)

January 19, 2006
I work for my surgeon handling among other things insurance and precertification. I have had quite a few medicare patients get approval for a panniculetomy...HOWEVER, the catch is that they won't approve it until AFTER the surgery. Then if they don't feel that it was medically necessary, you will be responsible for the entire cost. Thats why the office would have you sign an ABN notice. If you have enough documentation, you should be ok. Jessica
   — Jessica D

January 19, 2006
Talk with your PCP and see what they feel. My late husband had a panni done (before WLS) and it was covered by medicare. Im sure you have less to remove than he did (he had 85 pounds taken off) but still it was medically necessiary. Most 'normal' insurances cover panni' if medically necessary and I would think medicare would too under certain circumstances. I know medicare has a website on what they do cover (sorry dont remember the address) but I would also look there to to see what they have.
   — star .

January 23, 2006
Hello...I don't have Medicare, but I do have Tricare (which I think is really close to the same coverage)....but, when we lived in Virginia, and I was on a waiting list for gastric bypass surgery and went to the orientation, they told us all that skin removal was not a covered benefit, BUT, if you went to your doctor at least THREE times and told them your got rashes or irritation under the folds of the excess skin, then it is possible it would be covered that way. I hope this helps!!
   — jessica7552