I'm not sure about Medicare, but Medicaid pays for the surgery. A friend of mine got it. She had to buy the compression garments, but they covered everything else. She had to fight for it at first. It's automatically covered for those that get any of the surgical procedures for weight loss, however, she joined weight watchers, and lost over 200 lbs. It's so uncommon for anyone to lose that much without the benefit of a "procedure", it took a bit to get it approved, but they did approve it. She got her middle done first, then her arms, then her legs.