Question:
HAS ANYONE GOTTEN MEDICARE TO PAY FOR APRON REMOVAL,, IF SO WHAT ARE THE CODES?

ALL THE DOCTORS IN ILLINOIS ARE SAYING MEDICARE WON'T COVER IT YET I UNDERSTAND MEDICARE TO A NATIONAL INSURANCE. I KNOW PEOPLE IN PENNSYLVANIA AND OHIO HAD IT DONE WITHOUT A PROBLEM. SO WHAT MAKES ILLINOIS SO DIFFERENT THAT THERE IS TROUBLE IN GETTING IT COVERED?    — Beth S. (posted on December 19, 2002)

December 19, 2002
I'm not sure about exactly how the Medicaid in Illinois works, but I am on Medicaid in Michigan. Here we are required to chose a health plan that is basically paid for by the Medicaid system. Each plan is different and so you have to research exactly what you need when chosing one or switching plans when the time you are able to. I was able to chose from the five Medicaid plans offered in my county. And after calling each and every one, I found only one of the insurances would pay for anything related to weight loss surgery if it is considered a medical necessity. And I was lucky enough that this plan (Great Lakes Health Plan) would also cover the DS too =) But if you are on straight Medicaid, I would check with your social services worker...because I know that there is a process on which you can appeal a denial if they say no to you. Somewhere there is a rule that states if they provided the same procedure for someone else with the same health plan (because if Medicaid pays for it you know that they have deemed it a medically necessary procedure) that they have to cover it for you as well. That's not to say you wont have to jump any hoops, but is probable that you can receive the same procedure as well. Good Luck! =)
   — ImANewDee

December 19, 2002
My father had his panni last year and medicare paid the tab. The thing was, he lived in WV and was moving to CA. He actually had the surgery in PA. I really don't think that the state matters with medicare. Good Luck!
   — Beffy W.