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Daughter has medicare and masshealth?



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My daughter who is 26 is on medicare and also has masshealth for insurance. Does medicare and masshealth cover lap-band. She is looking into it. She has some issues, like being bi-polar which is why she is on medicare. Any advise?

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Hey babs! Medicare does cover lap band and MassHealth will pick up the remainder of what they do not cover. They do have many eligibility requirements though (ie hospital has to be a 'center of excellance'--they will broadcast this if they are, 6 month physician supervised diet beforehand, certain bmi and comorbidities may be required too). Can call medicare if you want to know the exact requirements, but my advise is to have her go to a seminar at the hospital she wants to have the surgery at and then to book a consult w/a surgeon. The staff at the surgeons office should be familiar with the insurances and be able to give you more concrete info too.

i am going to brigham & womens in boston which is a 'center of excellence'...most of the boston hospitals are. i am not yet banded and dont have medi/masshealth but at the seminar they went over the various insurances and their requirements so i remember this info.

hope this helped!

gina

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