Medicare coverage for panni removal?

jhpby
on 1/19/13 7:28 am - Oshawa, Canada
Hi everyone, just wanted to find out if Medicare will cover panni removals? If so, what kind of criteria needs to be met? Any suggestions for things I can do in the mean time to help with getting approval. I do have pictures from a time when I got an infection under my stomach so hopefully that will help!

Also, when/ where is the monthly meeting in Moncton?

Thanks for any help I can get!!!

Jenn
HW- 343     CW- 266.4  SW- 314                                        My  is suberman!       

 
Cindy F.
on 1/22/13 9:35 pm - Charlottetown, Canada
VSG on 02/05/13

From what I understand, they may cover the removal but it's typically only the lower portion of the stomach (ie, from the belly button down, thus leaving the middle sag untouched). I would document / date any pictures taken when you have rashes or irritations and get in to see your family doctor at these times if you can so they have a paper trail as well. That will help your doctor push for the surgery.  I would also document these problems in other areas of loose skin as well if you have them (arms, legs, breasts) as the doctor can make a request for plastics on those areas as well - all they can do is say no.

I think Dr. B. will send a referral for plastics if you've gotten under 200 or close to your goal weight and then it's about 6 - 12 months before you see the surgeon. Your family doctor can provide document to the surgeon as well. They typically want to see you at a stable or decreasing weight for a number of months (ie, that 6 - 12 month wait). That's my understanding anyway.

anitalynn
on 2/3/13 9:06 am

Hi there!


I had an abdominoplasty in September after losing 160 pounds with lap band.  The surgeon will want to be sure that you're at a stable weight first, and have remained at a stable weight for some time.

Medicare covered the panni portion of it (the lower part of the stomach "hang") and I had to pay for the difference.  So what that meant was that if a tummy tuck (full) is typically $8,000 you will only be responsible for $4,000.  Still a lot of money, but definitely a help.  There are rare cases where Medicare will cover the entire thing, but I definitely wouldn't count on it!

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