Question:
Does Medicare Pay For the Duodenal Switch surgery?

Does Medicare Pay For the Duodenal Switch surgery? I just found out that since I had the gastric bypass once before, the RNY might not be safe for me. It was said that the DS might be the best surgery for me. A doctor emailed me with this information. I think so also. I don't know if my insurance will cover the DS however. Does anyone know if Medicare will cover the DS if it is medically necessary? I would much rather have the DS if I have a choice, for all reasons. Can anyone help me with information on this subject? I am so happy that I found this great site. I feel like we are all family here.    — Richard P. (posted on April 28, 2003)

April 28, 2003
I don't have the answer to your question, but you might also try asking on the Duodenal switch web site: <br> <br> http://www.duodenalswitch.com/index.html
   — Lynne S.

April 28, 2003
Yes, the DS is a covered procedure when it is medically necessary. In Michigan those of us on Medicaid are required to choose a health plan that is offered for our specific county. I'm sure it may be different varying from state to state though. But when I was able to get Medicaid, I contacted each of the insurance plans offered to me and asked if the DS was a covered procedure since that is the only surgery I want. Out of the 5 I was able to choose, only 1 plan said yes it was covered if medically necessary - So that is the plan I signed up with. I know of others who have had the DS as well being on Medicaid. I believe that it must be covered as long as you meet the required criteria for the surgery. Please check with your case manager just to make sure though.
   — ImANewDee

April 29, 2003
I live in Florida and had the DS thru another insurance. I was told that Medicare would pay for the DS for the hospital but not for the Dr. Good luck. Leslie Elwood
   — Leslie E.