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