Cool Headed

Don't have the Gastric Bypass unless you have a lot of health issues for now. Gastric Bypass is out dated for the time we are living in. Gastric Bypass is not as safe as Sleeve surgery plus it causes ulcers, bleeding, dumping, no Nsaid for pain,& I just read an article that VSG patients outlive Gastric Bypass patients 5 times longer. People have been waiting since 2009 for Medicare to pay for VSG Surgery and when I had my surgery Dec. 15, 2010 Medicare still is not covering VSG Surgery.

Yes I checked with BC/BS PPO back in June 2010 and they told me that Medicare does not cover VSG surgery but they do. I was told by BC/BS PPO that I met their requirements and they would pay even if Medicare denied it. I have to wait & see if this is true. Shady Grove Hospital did not bill BC/BS because they said if Medicare did not pay for the surgery neither would BC/BS. BC/BS told me that is not true so I called Shady Grove Hospital and told them BC/BS want my claim to cross over to them and they will decide what to do. Shady Grove filed a claim with BC/BS after I insisted they do and start doing their job correctly. I have at least 30 days until I find out what is up. The surgeon does not take any insurance except Medicare so I need to appeal Medicare decision because until Medicare agrees to pay the surgeon I am in for $9000.00. BC/BS may pay him some money for the surgery if they pay some on the hospital. Medicare needs to get with the times & recognize VSG surgery. Gastric Bypass is becoming obsolete because VSG is much better surgery and allows the patient a normal way of living. I can eat most anything now except in smaller portions. I continue to lose weight and I feel great. No Dumping.

Hi I was sleeved on Dec. 15, 2010. Medicare denied my claim. Has anyone appealed Medicare and won. I need help to get Medicare to pay for the VSG surgery. I was obese, Type II Diabetes not controlled. Diabetes showed up in my left eye in May of 2010 and I got really frighten that if I did not do something soon I could go blind in a few years. I also was afraid the Diabetes would soon attack my body in different places because my A1C was 9.4. Somethin would happen in middle of night to drive my morning reading to be 250 to 325 and the Specialist after 16 months could not get this to stop happening to me. I read about the VSG having great results getting Type II in remission so I got the surgery. My Type II Diabetes is in remission and my A1C came back 6.2 since Dec. 15th. My morning readings are 90 to 110. I have lost 51 pounds so far. I am 61 years old. Please help me if you won a appeal against Medicare. Thanks

I do not know, however I got an e-mail and someone in California said Medicare paid for theirs. Medicare is a federal program and I would think if Medicare paid for one surgery they would pay regardless of where the person lives, however I found that is not the case. My surgeon said Medicare has a code and has not used it yet to pay for VSG. I want to appeal their decision because I believe VSG was right choice for me. I also have BC/BS PPO as my second insurance. Hospital told me if Medicare does not pay that your second insurance will not either. I said that is bull. I called BC/BS and they are looking into my case. Cool Headed.

Medicare believes VSG is still new and they need more time to evaluate the surgery. Medicare believes Gastric Bypass is the way to go since they have more data on the surgery and it has been around longer. Please. Medicare is behind times. VSG is the only surgery a person should be having now. No malabsorptive complications, use Nsaid for pain, ulcer less likely & life expectancy is 5 times longer than Gastric Bypass procedure. Fight for justice. Cool Headed

Good Luck. I had the surgery in Dec. 15, 2010 and Medicare will not pay one cent toward my bill. I no longer have Type II Diabetes. Praise God. I no longer have depression because my Type II Diabetes is no longer attacking my body. May 2010 I was told by my eye doctor that diabetes was in my left eye and right then I had enough. I made an appointment next day and began my journey in July 2010 toward VSG surgery. I need two knee replacements and I was not about to give up Nsaids for pain. My doctor tried me on topical Nsaids and I had a severe reaction to the medication and had to stop immediately. No way I was having gastric bypass & suffer with pain all the time. I hope some one out there can help me with appeal. I need Medicare to pay for this surgery. I was billed $10,100.00 for hospital expense and I had to pay $9000.00 up front to the surgeon. I am on a fixed income. I am not giving up having Medicare pay this bill for VSG surgery. I am going to fight their decision all the way. I want every one to have VSG surgery that need surgery. I just research some more on why a person should have VSG & not gastric bypass and the information I read said VSG people live 5 times longer than Gastric Bypass people. Cool Headed

Sorry to tell you that on Dec. 15, 2010 I had the VSG and Medicare refused to pay one cent on the operation. I want to appeal their decision and if anyone appealed Medicare & won I need desperately to hear from you. My hospital bill was $10,100. and my surgeon fee was $9000.00. The surgeon I had to pay up front before surgery and the hospital allowed me to have the surgery and now want their money. I am doing remarkable. I have lost 55 pounds and my Type II Diabetes is in remission. I had no complications from surgery and I feel great. I am 61 years old and feel like I am forty again. I have so much energy now. I encourage anyone who is over weight and have health issues get the surgery. I am so happy I had the surgery. My health has improved greatly. No more Insulin, Byetta, Glipizide, Blood Pressure pill and my Lipitor is ready to go. My family doctor was against me having this surgery, however since seeing me doing so well she wants to have some of her patients to go to & get the surgery. Cool Headed.

Hi, You may not have the energy because you may not be getting enough good carbs. My nutrionist ( Mandy ) told me not to go below 30 carbs ever and go up to 50 carbs if I exercise. Mandy said if you go under 30 carbs you will get sluggish. Monitor your carbs every day.

No. I take tthis medicine for high blood pressure.

Hi Everyone. I had my sleeve surgery Dec. 15, 2010. I am off the 5 week liquid diet and I am eating soft foods. I have lost 39 pounds total since July. I lost 18 of those pounds since my surgery on Dec. 15th. 2010. I have Medicare so I had to pay the surgeon up front. I plan to appeal Medicare if Medicare declines to pay for the surgery. I had a low BMI and the sleeve was a better choice for me instead of the Gastric Bypass. I had the weight loss surgery to get my diabetes under controll. The surgery has helpme to get my Diabetes under controll. I am off Insulin, Byetta & Glipizide. My blood pressure is coming down so I had to stop Cozaar and cut my Metoprolol in half for now. My family doctor said I will have to stop Metoprolol soon as I drop more weight. I urge anyone who is over weight and have health issues to have the Gastric Bypass or Sleeve surgery. Dr. Greene was my surgeon and he is awesome. I am 61 years old and had no complications from the surgery. Dr. Greene accepts Medicare and he is Chief of Staff at Shady Grove Hospital in Rockville, Maryland. I feel great. The soft food is going down without sticking. Yeah!!! January 16th. 2011 I will start to eat Hamburger, chicken & Turkey. I hope I will be able to eat the new meat without problems. Cool Headed

Please post as soon as you know that medicare is covering VSG surgery.

I am also starting the process. I have 2 months of diet history completed. My Surgeon said Medicare is not approving the Sleeve Surgereon as of now... I also want the Sleeve operation. I am praying that medicare will approve the VSG in January 2011. I understand Medicare has a code for the procedure now so maybe they are getting ready to make the change in October 2010. There are a lot of people wanting this procedure and are holding off to see what medicare does in October 2010. My 6 month diet ends Jan.7, 2011 & I was told there is another 6 to 8 week after the diet ends before Surgery is scheduled. The insurance companies review all the paper work before they say yes to the surgery. Cool Headed

The answer is No. My surgeon just told me July 19th. :nono:

I was told by my Surgeon July 19, 2010 that Medicare does not pay for the VSG.

I am going to have surgery in Jan. or Feb. 2011. I just started my Diet July 7,2010. I want the VSG, however My Doctor informed me Medicare does not pay for VSG. I do not want Gastric Bypass because I am afraid of the malabsorption problem and the dumping sym. I also do not like the intenstine being cut & moved up to the stomach pouch. Does anyone know if Medicare will be approving VSG in 2011?:thumbup:

Thanks. I will pray for you also. I am praying that come January 1, 2011 any one wishing a VSG procedure Medicare will start approving this surgery.:nono: