Does Medicare Cover Lap Band Surgery?

Learn if Medicare covers Bariatric Surgery

by Amy De Vore+ on Jun 25, 2015 | 5 Comments

The lap band is officially called laparoscopic banding surgery, and it falls under the category of Bariatric surgery, along with gastric bypass. These types of surgeries have specific conditions before you can qualify. Lap Band and gastric bypass surgeries can be very expensive and many wonder if Medicare covers it.

Does Medicare Cover Lap Band Surgery?

Yes, Original Medicare partially covers bariatric surgery for lap band and gastric bypass when you meet certain medical problems and/or conditions as a result of being morbidly obese.

The costs break down in the following way:

  • For lap band out-patient care you would owe 20%, plus copays, and your Part B deductible $185)
  • For lap band in-patient surgery you would owe your Part A deductible $1,364, and may owe coinsurance

Lap Band surgery ranges from $10,000 to $33,000 in the U.S., according to Bariatric Surgery Source.

Does Medigap Cover Lap Band Surgery?

Many of your Medigap options can cover all or part of your Original Medicare out of pocket costs for lap band surgery. Remember that, although many Medigap plans will cover a lot of your costs, only “C” and “F” cover your Part B deductible. If you enroll in C or F, most clients find that they don’t have any additional out of pocket costs after their premium for lap band surgery. Which as you can see from the above amount, could save you alot.

Learn More about Medigap Get a Medigap Quote

Does Medicare Advantage Cover Lap Band Surgery?

Your Medicare Advantage plan (MA) should cover your lap band surgery; however, since MA plans vary on how they offer coverage you’ll need to research how each plan offers coverage.

Learn More about Medicare AdvantageGet a MA Quote

For further questions please contact a Senior65 agent at 800-930-7956.

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Reader Comments and Questions

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By Nada on March 27, 2019

I am overweight I'm just wondering if lapband is covered on medicare if I have alot of medical issues like high blood pressure,diabities,cholesterol,and also a fatty liver

Nada,
As the article states, Medicare covers lap band surgery when you fulfill some requirements. Having an illness like diabetes is one of them but there are others. Please contact Medicare directly with this issue.

-Chris from Senior65.com


By Janice Cain on November 26, 2015

I have Medicare A & B also a secondary insurance, American Pioneer. I am a Duabetic on an insulin pump and about 75 pounds over weight. I wanted to know if Medicare and secondary insurance cover lap band surgery.

Janice,
Medicare does cover their portion of Lap Band surgery. If you have Medicare Supplement Insurance, then yes, but, unfortunately, we aren't familiar with American Pioneer, and not sure how they would cover you. You would want to contact them directly. Best of luck!
-Amy from https://www.senior65.com/


By Alicia Greenberg on August 13, 2015

I need lap band surgery but I can't afford Medigap for the long-term, but I can't afford the out of pocket costs for the surgery. Can I enroll in Medigap for one year and switch to Medicare Advantage the following year?

Alicia,
Yes, you can switch from Medigap to Medicare Advantage. The thing you want to remember is it will be hard to switch back to a Medigap plan if you have preexisting conditions. Hope this helps!
-Chris from https://www.senior65.com/


By Brandy on July 02, 2015

You're recommending C or F, but those are the most expensive. Are there any plans that can cover those costs that are less expensive per year?

Brandy,
You're 100% right, these two plans are usually the most expensive Medigap plans; however they do cover the most. So, if you are willing to pay the Part B deductible out of pocket , then there are quite a few other Medigap options.
-Chris from https://www.senior65.com/


By Wondering Watson on June 25, 2015

So the best way to save money on a lap band surgery is to exercise and eat all natural non-gmo produce.



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