Does Medicare Cover Weight Loss Surgery?
The original question on many people’s minds these days is, “Does Medicare cover weight loss surgery?” The answer to this question can be found in the new Medicare supplement called the Medigap Plan. As with any other supplemental insurance plan, Medicare Part A and Part B have a standard definition of what is considered to be a pre-existing medical condition. The intent behind this standard is to prevent individuals from being denied coverage for any illness or injury that they might have had in the past. It is important for individuals and families to understand this standard when considering their options regarding health insurance.
What exactly is meant by “pre-existing”? It means that the condition must have occurred at some point between the date of birth and the date of applying for coverage. So, a patient applying for Medicare supplemental insurance plan benefits will need to be able to prove that he or she met these criteria before losing any weight. This proof can be difficult to provide, particularly for individuals whose weight loss surgery was recent. This is especially true for those who have cosmetic surgery such as liposuction or a gastric bypass. Even for those who have had one or more types of weight loss surgery, proving the loss before enrollment is crucial in order to avoid disqualification from Medicare Part A or B.
So does Medicare cover weight loss surgery under the Medigap Plan? The short answer is “if you are enrolled in Medicare Parts A or B”. It is important for individuals and families to understand that this particular plan applies to all of their medical expenses, not just Part A or Part B. In addition, even if you meet the standard requirements for Part A or Part B, you may also be subject to additional Medicare surcharges and/or premium payments based on your health status.
There are several additional plans that do provide coverage for surgeries of all kinds, regardless of your current weight. For example, there is the Medicare Advantage Plan which covers all types of surgery, including those that are considered elective. Depending on the state you reside in, there are also supplemental insurance plans that may provide coverage for your loss of weight.
Before signing up for a plan, it is important to understand the type of coverage that is available. For example, not all weight loss surgeries qualify under Medicare. As an example, gastric bypass and lap-band surgery procedures are not eligible. Nor do any weight loss medications or drugs that are used to treat obesity qualify under the plan. Individuals who are considered very obese (more than 50 percent of your body mass) are also excluded from coverage.
Some private insurance companies also cover weight loss surgery. However, these companies typically only offer coverage to elective surgeries, so it is important to do some research to determine if your doctor’s surgery procedures qualify. If you are interested in gastric bypass surgery, your primary care doctor should be able to tell you if it is covered by Medicare. You should also check with Medicare Part B to see if your diabetes medications are also covered with this plan.
In addition to gastric bypass surgery, other weight loss surgery options may be available to you. A number of different options are available, depending on your age, medical condition and other factors. If you are obese, losing weight can sometimes be difficult. To lose weight, one option is to enroll in a surgery program that will help you lose weight through diet and exercise. Although Medicare does cover some weight loss surgery, it is important to understand how the plan works and if it is right for you.
With many people being overweight, gastric bypass surgery is becoming more popular. Although Medicare does not cover this surgery, it does cover many other weight loss surgery procedures. It is important to understand exactly what your coverage is and any limitations. Although Medicare does not cover weight loss surgery, there are still some great weight loss surgery options available. Your physician can explain your choices and give you a better understanding of the surgery.