What types of skin removal does medicare and medicaid authorize?

marty69
on 8/6/12 10:14 am - MO

RNY on 06/06/12

I have had my surgury and am now thinking ahead to dealing w/all of this skin. I am disabled and recieved madicare and medicaid in missouri. Does any one know what types of procedures are covered under these coverages. Or perhaps where I can find this infomation on line?. Thanks Again for all the help and WONDERFUL advice I ALWAYS recieve on this site.

     May We All be Blessed and Valued

                          marty

Ladytazz
on 8/6/12 2:10 pm

I'm on Medicare, too, and they paid to have my panni (the apron of skin that hangs over your pubic area) removed. I was told they would do it if it was "medically necessary". They may also pay for a breast reduction if you are having any issues. I would assume that they pay for any skin removal as long as it is deemed medically necessary. I wasn't happy because I couldn't figure out a way to convince Medicare that having perky breasts was medically necessary.

WLS 10/28/2002 Revision 7/23/2010

High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.

terilynn112
on 8/6/12 11:18 pm - maryland, NY

RNY on 01/11/11

my panni is being paid for by ny medicare/medicaid.

Teri
Lapbanded 9-16-08 revision from Lapband to RNY on January 11, 2011
HW 273/ 1st surgery 243/Lapband removed 260/ Current 172/ Goal weight 169

bvom
on 8/6/12 11:49 pm, edited 8/6/12 11:49 pm - CT

RNY on 10/14/08

If your panni overhangs your pubic area and you have documentation of rashes, they will pay for removal. Remember, a panniculectomy is NOT a tummy tuck - it is not pretty at all - it just gets rid of excess.

In some (rare, as I understand it) cases, they will also pay for breast reduction.

Also remember - technically speaking, Medicare does not pre-approve anything. Your doc will determine if they think they will - then they perform the surgery and submit it for approval/payment.

Source? Had a panniculectomy while on Medicare/Medicaid (in Massachusetts) in 11/09.

Highest: 601 lbs / Surgery: 573 lbs / Lowest: 242 / Regained 57 lbs (Currently -51!)
Panniculectomy 11/09 * Brachioplasty & Inner Thigh Lift 12/10

marty69
on 8/7/12 7:18 am - MO

RNY on 06/06/12

Thank You all so much . I have a HUGE pannie and my Dr has been talking about getting it off even before I had my wls done. I have had skin issues sense I was in my 20's , under my breasts and my pannie. So it is a relief to know that coverage is possible.
While I imagine most of us would love to have a tummy tuck (my self esp) just having this removed would make thing soooo much better.