weight loss surgery diet
Does medicare and medcaid cover weight loss surgery? Do they require the 6 month supervised diet?
I am dissabled and I have medicare as my primary insurance and wisconsin medicaid as my supplement. Also do they require the 6 month doctor supervised diet like other insurance companies do? Thankyou for all advice. btw I'm a 22 year old female, my primary doctor thinks the surgery would greatly improve my health and possibly resolve my type 2 diabetes, I go for the orientation next wednesday august 19th and then my consult with the surgeon is august 24th. Once I think about it, I doubt they would have set up my appointment if my insurance wouldn't pay for it. But I would still like to know about the 6 month supervised diet thing.
There are 5 basic types of bariatric surgery. Medicare will not cover sleeve gastrectomy or vertical gastric banding. They will cover Roux-en-Y bypass (RYGBP), Biliopancreatic Diversion with Duodenal Switch (BPD/DS), and Laparoscopic Adjustable Gastric Banding (LAGB) under they following conditions: You must have a BMI of greater than 34, you must have at least one co-morbidity related to obesity, and you must have been previously unsuccessful with medical treatment for obesity. In addition, these procedures are only covered when performed at facilities that are certified by the American College of Surgeons as a Level 1 Bariatric Surgery Center or certified by the American Society for Bariatric Surgery as a Bariatric Surgery Center of Excellence.
You can find approved facilities by searching on this website: http://www.cms.hhs.gov/center/coverage.asp If you contact these facilities they will help your further.
Your Medicare will be primary and Medicaid will usually pick up most if not all costs that Medicare will not pay. However, that is dependent upon your state and your Medicaid level.
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