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Re: Will medicare pay for a revision?

Posted: Wed Dec 06, 2023 10:19 am
by October26
beachbum1 wrote:Just seen this thread. I just got a
Replacement. 08/23/23. Medicare has paid for both the original and the replacement. As others have said, once your are eligible for Medicare and sign up, be sure to get a supplement plan with someone. My replacement, Medicare was billed I think somewhere around $22000+. Medicare approved I think $17000 and paid 80% my suplamental insurance covered the 20% cost me nothing out of pocket.


I am just curious to ask if your replacement was the same size as your original IPP? Also, how did it go?

Re: Will medicare pay for a revision?

Posted: Wed Dec 06, 2023 3:06 pm
by beachbum1
To answer your question, my revision is 2 or 3 cm larger. Day after surgery when my Dr removed the catheter i asked and he said he put in a 21+ 3. Said he measured 11 down and 12 up. My original was 18 + 3. But i think he ment 21+2. Hope 3 was correct. Haven't received the patient id card yet. Its been almost 4 months and i now measure just about 3/4" longer and 1/2" larger in girth. I've got the AMS 700 lgx so may, and should according to AMS, a bit more.
The surgery was a breeze. Everything came out without any issues and went back in easily. after 2 or 3 days couldn't hardly tell i had surgery. only real pain was the catheter and some soreness which went away quickly. was able to inflate and deflate in 2 days . Only gave it a couple of squeezes then let it off. Nearly no swelling and bruising. Couldn't have been happier.

Re: Will medicare pay for a revision?

Posted: Wed Dec 06, 2023 3:12 pm
by Hillywilly
I may be mistaken but I have heard you CANNOT be denied coverage for an implant replacement once you've already had one placed for medical necessity. Hopefully that is the case. Anyone else heard that?

Re: Will medicare pay for a revision?

Posted: Wed Dec 06, 2023 4:34 pm
by LMCatman
My regular health insurance paid for my first implant and my first revision. Medicare paid for my two subsequent revisions. Good luck man!

Re: Will medicare pay for a revision?

Posted: Wed Dec 06, 2023 11:58 pm
by oldbeek
I also think you can sign up for medicare 3 months before you turn 65. Cneck it out.