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U.S. News

Medicare to Pay for "Fillers" in HIV Patients

March 26, 2010

On Tuesday, the US Centers for Medicare and Medicaid Services (CMS) said Medicare will cover the cost of facial filling treatments for HIV patients with facial lipodystropy syndrome (LDS) who are also depressed.

CMS said a review of current data found use of dermal fillers such as BioForm Medical's Radiesse and Sanofi-Aventis SA's Sculptra benefitted HIV patients with facial fat-wasting who also experienced depression. Other HIV patients with LDS will not be covered, the agency said.

Approximately 45 million elderly and disabled Americans have health care coverage under CMS.

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See Also
An HIVer's Guide to Metabolic Complications
TheBody.com's Lipoatrophy Resource Center
Ask a Question About Facial Wasting at The Body's "Ask the Experts" Forums
More News and Viewpoints on Facial Wasting and HIV/AIDS

Reader Comments:

Comment by: Michael B (Redding, Ca.) Sat., Oct. 17, 2015 at 4:44 pm EDT
As a 23 year Aids survivor I recently received Sculptra dermal fillers. The doctors office had told me the service was covered by Medicare. After the 2nd of a series of 3 injections I received a denial from Medicare stating the first 2 services were not covered. I was billed for a significant balance of charges. It wasn't until I paid the balance when I later learned the charges were billed with the incorrect ICD-9 code. The reimbursement rate is $100.00 which in my opinion is a slap in the face to any physician, especially when they accept Medicare assignment. I was told I am responsible for the balance, which is why I paid it. The office manager was adamant that I had signed an agreement to pay any balance not covered by Insurance (Medicare). I didn't think one could bill a patient for the balance if they accepted Medicare Assignment. Yes, I know this is not particulary an Aids related topic, but rather a business office question. Should I have paid the balance? I am so frustrated by all of this. Medicare does not generally cover fillers, but an exception was made for those living with Aids as ones appearance is affected resulting in depression.

Thank you so very much.
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Comment by: Gary DeBaun (Key West,Fl.) Sun., Jul. 21, 2013 at 9:54 am EDT
Does sculptra offer a free patient assistiance program for hiv facial wasting? If so how do I get an application? Thanks!
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Comment by: Flo (New Jersey) Wed., Feb. 13, 2013 at 12:32 pm EST
I was trying to figure out how to acess the paperwork tho see if I could get my medicare to cover the cost of my facial filler. Though I am on the paitent assistance prograg it still isn't enough treatment for satisfactory results. Do other folks have this same problem with getting really good results to last. It's like my face just eats up the filler that is injected. And then the assistance program won't cover any additional product .
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Comment by: Gary (Washington Dc) Fri., Apr. 2, 2010 at 11:21 am EDT
There are many people with HIV that suffer from facial lipodystropy syndrome (LDS) and who also experienced depression and have health insurance through there work. Do you think they will every change this so our health insurance will cover this.

Gary
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