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.

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 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

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.