Question:
Has anyone had plastic surgery that was covered by medicare after WLS?

I am on Medicare and am in process of getting pre-op testing for RNY. I have over 300 pounds to lose and am wondering if there is anyone who has had Medicare pay for reconstructive plastic surgery after WLS. I am also interested in corresponding with anyone who has lost or is in the process of losing 300+ pounds. I am new to OH and hope that this post is okay.    — [Deactivated Member] (posted on November 19, 2008)

November 19, 2008
Shelley, Congrats! At least you are making a start. Losing that much weight you want to be very careful and have a very good bariatric doctor. Look specifically for plastic surgeons that do a procedure called panniculectomy and related procedures. I once was 420 pounds and I am now 200. Its a real challenge not to lose weight because your body starts to suffer with diabetes type 2, metabolic syndrome and other related illnesses. I do feel better but not at goal yet. If you want to communicate further; [email protected]. vinnigirl
   — vinnigirl

November 19, 2008
Is Medicare only for USA or are they also funding surgery to India? I would be very interested to know. Good luck with your surgery and your path to ideal weight loss. Wish you all the best
   — [Deactivated Member]

November 19, 2008
Medicare only covers procedures in the USA. I also have medicare and was told by my hospital staff that if I was to have plastics I would have to pay for it out of pocket and cross my fingers for a reimbursment. Sometimes they cover it, sometimes they don't. So, from what I understand, it's like winning the lottery, pretty much. Good luck.
   — maria09elena

November 19, 2008
Hi there, I'm on your same road. I probably need to lose 280 or so, after I've now lost about 80 pre-op on my own. I'm opheliafl on here, feel free to add me as a friend and good luck!
   — opheliafl

November 20, 2008
I have a medicare advantage plan called healthnet ruby plan 2 which is a hmo. It coved my revision from a rny to erny. It covers plastic surgery if it is medically neccesary. Like if you have chronic infections of your skin and it is well documented from your dermatolgist to your pcp. Good luck, Dawn
   — [Deactivated Member]

November 20, 2008
I also forgot medicare is a federal plan. It is not world wide. We pay thru our taxes to have it.
   — [Deactivated Member]

November 20, 2008
As long as you need the procedures done. And you can prove them to be medically necessary. If you have rashes for example. Medicare and Medicaid will approve the procedures. I have have lost 315 pounds. I have had my arms and pannectolectomy done. Nov. 17th I had my inner thighs done. Check out www.myspace.com/kemalani that is my webpage. email me at [email protected] if you have any questions or just want to chat. Thanks Kemalani
   — kemalani

November 22, 2008
I have medicare and at my first plastics consult was told that I had to pay $5680 up front for hospital and drs fees to have the 6-1/2 inch panni removed. Medicare gave me the code to give to drs office to put on form for panni removal to be covered but they would not do it due to the dr wanted to not have to wait on medicare to pay him. In order for me to get panni removal paid for and or total body lift I would have to find a dr that would accept medicare payment and wait on his payment from medicare. The only dr that would do this for me is over 300 miles away and it is not possible for me right now or in near future. Documenting the rashes and or skin pulls and whatnot have done that and is more money to spend on my inclme not able to do. Medicare will pay it is just the right code to put on forms and dr accepting his payment whenever medicare pays him. I would also have to be responsible for my 20% as usual to hospital which would be around $1027 as out patient. I wish you luck in this journey of yours and calling medicare would be a good thing to do to get an understandin about what is covered and not.
   — mspisces