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Facial Lipotrophy Treatment and Medicare Advantage

Apr 15, 2014

My understanding is that if you are on a Medicare Advantage program (I have Anthem Blue Cross Medicare Preferred PPO) you do not qualify for the patient assistance programs that are offered by the makers of Sculptra and Radiesse. If that is the case how are the Medicare Advantage programs in paying for the treatment of HIV related facial lipotrophy? How much will I have to pay for the product and service? Thanks.

Response from Dr. Pierone

Hello and thank you for posting.

There are literally thousands of different health insurance programs available around the country. Each one has its own peculiarities and coverage decisions.

The best advice I can give you is to engage with your insurance company as well as the health care provider that will be performing the procedure. If you don't get satisfaction from the insurance company, then start the appeals process. If that does not work out, then go to the regulatory agency in your state that manages a health insurance companies. I also think it would be in your interest to engage in discussion with the patient assistance program administrators.

Good luck!

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Facial Changes on HAART

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