Question:
How can I get someone to do tummy tuck with Medicare!!

Is there anyone out there who could tell me of someone in NC or SC that would do a tummy tuck for me. Everyone I have called so far has acted rude when I mention medicare , they say don't do this because it's not medically needed and they will not even file for medicare to pay for it. They immediately get on the offensive. When I ask them if they know of anyone that will do this they say they don't know of anyone. I had gastric bypass 3 years ago and have a lot of loose skin that needs to go. I just thought since I have Medicare anyway, and Medicare payed for my gastric bypass that it wouldn't be too much to ask for someone to try to use Medicare for my tummy tuck. I don't consider it cosmetic I consider it as skin that gets in the way of walking and does have rashes other problems. If anyone knows of anyone who would do the tummy tuck or what are the rules of offices not using Medicare, please answer. Thank you so much in advance. I don't know where to turn for answers about this.    — tatterpuddin (posted on October 10, 2005)

October 10, 2005
You might post your question on the N.C. and S.C. forums. Best of luck. Kasey 365/215/195 (nonop)
   — Kasey

October 10, 2005
You might want to go to the Plastic Surgery Message Board and read some of the back message, this subject has been covered over and over. I have Medicare and I have Tricare Prime as my secondary insurance. Medicare is totally different when getting WLS surgery and Plastic surgery. Medicare does not approve or disapprove plastic surgery and you will find it hard or next to impossible to get any plastic surgeon to do any medically necessary or not plastic surgery and not know if they will be paid. If you have a second insurance, check and see if it covers any reconstructive surgeries. That will be your only chance to get ps done by insurance. If you could find a ps that would do the surgery, Medicare may pay on part B, but you could be left with the hospital bill, doctor and aneacealogist bill that will run into the thousands. I have had a breast reduction, and a tummy tuck w/hernia repair, and Medicare did pay a portion of the Part B, hospital and supplies, but my second insurance paid everything else.
   — cindy

October 11, 2005
One bit of info I can offer is to not call it a tummy tuck when you are asking the questions on the phone with docs. Call it a panniculectomy (pannic-u-lec-tomy) I may have it spelled wrong but that is how it is pronounced. There is a huge difference where they are concerned. A panni removal is not cosmetic. Good luck... Julie
   — J. Stinard

October 12, 2005
The plastic surgeon I had who came highly recommeneded would only do a pannus removal and now everything above the belly button is worse than before. He stated that in his 20 year experience Medicare would not pay for anything else regardless of infections or documentation. He did offer to do more on a cash basis for around $12,000. Good luck.
   — Irislady

October 21, 2005
This is really a problem, because a panniculectomy is NOT a cosmetic operation. To get the abdomen back to normal, the surgeon needs to do liposuction, make a new belly button, reduce the pubic area, lift the leg and thigh skin, and balance the hips and waist. Those items make it an 8 hour surgery, and nobody is really interested in covering it. In my opinion, it is a reconstructive, not cosmetic procedure as patients simply want to be restored to something near normal.
   — DrL

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