Question:
Will Medicare pay for WLS/fundoplication together?

My mother has Wal-Mart AND Medidcare. Medicare will only pay for what Wal-Mart does--which is NO WLS, period. She has had a gastric banding and needs both some type of WLS revision and a fundoplication for severe reflux/Barrett's esophagus, desperately. Is there any way to combine the surgeries so that Medicare will pick up the tab for both? Or even to self-pay the surgeon for the WLS and have Medicare pay for the other surgery/anesthesia/hospital time, etc.? Especially if she doesn't stay in hospital longer than she would have with the fundoplication alone? Finally, should she dump the Wal-Mart altogether, because then Medicare will pay for whatever Medicare pays for--which is probably more than Wal-Mart does regarding WLS? (BTW, she will probably have Ernest Rehnke, of FL do her surgeries.) Thanks in advance for any help/advice!!    — [Anonymous] (posted on October 14, 2000)

October 20, 2000
Roux-en-y gastric bypass, alone, is a surgical treatment for chronic esophagitis from severe reflux, since dividing the stomach separates the esophagus from the acid-receiving part of the stomach. If your mother is also morbidly obese (BMI of 35 or greater), Medicare would probably pay, after making her jump through their standard hoops.
   — Linda B.