sdb1147

5/3/2012

Hi Again sdb1147,

Yes, it is confusing.

I heard of a person from washington traveling to another state as medicare would pay for their band if they went to another state! Truely confusing.

Sincerely,

Reaching for the stars

I might consider having the procedure done out-of-state, but I'm hoping to have mine done at Swedish in Seattle. Primary care doctor just faxed her referral letter today, so hopefully I'll hear from them soon.

@MariNYC. Hang in there and keep your chin up. I share your frustration. I cannot understand why/how Medicare will not approve sleeve surgery, but they approve a much more complicated one: Rou-en-Y (?). Much more complicated surgery and one that forces individuals to consume multi-vitamins & supplements the rest of their lives because the surgery by-passes at least half of the digestive system. I might consider Lap-Band as my Plan-B, but I'm still focused on the Vertical Sleeve surgery. Don't like the fact that a foreign object is being place in the body.

I received a call from Swedish Hospital here in Seattle, WA informing me that my weight loss surgery had been approved. I'm waiting for my primary care doctor to forward a referral letter, then I'll seen what happens from there.

In the meantime, don't give up. Journal. Put your thoughts down in a notebook (I'm keeping my thoughts/notes on a steno pad). After you've entered your thoughts/input, leave them there...in the notebook. Don't carry around all that 'stuff'.

Keep this thought in mind, the Lord is always watching over you.

God bless.

Majority of the times, I don't think my insurance reps even understand themselves. Lol

Anjelika, I'm from Hawaii. Originally from Hanalei, Kauai, but raised in Kihei, Maui most of my young life. I've been WA for 30+ years now.

If you or your husband is in the military, won't they pay for weight loss surgery?

Wish me luck on my journey, which continues...

I just wish Medicare would treat every state the same wth respect to sleeve surgery. Why is it approved in some states & even recommended by doctors, yet in other states the only procedures recognized are the Lap-Band or Rou-en-y? However you spell it!

Hi Sdb1147,

I am just starting my serious journey on the insurance topic also.

I went to the seminar at the Swedish and I was kind of disappointed with them as they relyed back that I did not elect to have WLS in my insurance package. Then I heard another person tell me they were told the same thing. Confusing as no one ask me one way or the other when I bought my coverage.

I am not yet, so sure, that they pay for the sleeve either as it hasn't yet been FDA approved where as the band has.

So I am where you are except I am dealing with Regence.

It is my understanding that medicare writes the rules and the insurance companys follow suit. Medicare has a web site is is: www.medicare.gov and there office in Seattle phone # is: 1-206-615-2313 or 1-800-633-4227. Maybe they will tell you what to do.

There has to be many people out there in Washington that maybe could help us with this issue. So please experiance sleevers help us through the horrible insurance maze with information. :wub:

Any information regarding the truth of the matter would be greatly appreciated. Thank you so very much. We will be looking forward to your rely.

Sincerely,

Reaching for the Stars

Thank you so much 'Reaching for the Stars' for your feedback & information. I just posted a reply to Cherry bomb who indicated Medicare paid for her vertical sleeve surgery. I think she's in Florida, but I could be wrong. In any event, why does Medicare approve sleeve surgery in one state, but not another? Makes no sense at all.

The last thing I read was that Medicare was to make a ruling on the procedure by the end of March-2012. So, I'm holding my breath, but in the meantime, I'm dong all the preliminary stuff.

The journey continues...

Hi @Cherry bomb & thanks for the feedback. I wish Medicare/Medicare would get there stuff together in every state. Here in WA I'm being told that Medicare won't pay for vertical sleeve surgery, but will pay for the others. Apparently, vertical sleeve surgery is a relatively new medical procedure with not enough facts & findings...yet.

I've asked my primary care physician to forward a referral letter for me & now I have to come up with a million records of past weight loss attempts. I have no records to speak of other than memory of trying one failed diet pan after another for the past 20-30 years.

So, wish me luck. At least (on the positive side) it's a start. I plan on volunteering myself as a case study for the vertical sleeve procedure if it's data they want. I've studied the other choices & I've come to he conclusion that the vertical sleeve is the way to go.

I'll keep everyone informed as to my progress.

I just found this group/link, kinda by accident while browsing thru the website. Hello to everyone in WA. Thought for a while I was the only one in the state that was looking to do weight loss surgery.

I was notified by Swedish Hospital that Medicare had given their initial approval for funding my surgery. The only thing is, I want the Gastric Sleeve and they haven't yet approved this method. Thinking of going with the Lap-Band. Not sold at all on the "Y" surgery as it seems to be the most invasive.

I need some hints (help). Swedish says that Medicare wants information as to attempts at previous weight loss diets/procedures, etc. Even though I've attempted many, I don't have records and dates completely fail me.

In the meanwhile, I've contacted my Primary Care Physician and asked her for a letter of referral.

I would really appreciate any hints or ideas as to how to document prior diets.

Thanks.

Congrats! My surgery is this coming Monday' date=' May 7th and I am very excited![/quote']

Hi Vicki147. I just heard from Swedish Hospital in Seattle that Medicare has approved my weight loss surgery. Asked my primary care doctor to submit a letter of referral & I have to come up with a list of previous attempts at weight loss. Don't know how I'm going to do that. So, I'm on my way!

Thanks Kathy & good luck on your journey.

I spoke with Aetna Ins. today & was told that if Medicare doesn't accept a particular surgery, then neither will they.

So, now I'm down to plan B: either Rhoen-Y or Lap-band. No gastric sleeve. Leaning towards the band.

I'll post what happens in the next few days/weeks.

Majority of the times' date=' I don't think my insurance reps even understand themselves. Lol[/quote']

Attended another seminar for weight loss surgery last night. Was told up front that Medicare will NOT cover the sleeve procedure. They will however check with my supplemental coverage (Aetna) to see if they will. Oh, the forms to fill!

I hope they approve it as well! Good luck on your journey.

Me too! All this Medicare/Aetna insurance stuff is enough to drive one crazy. They speak in languages only they understand.

Thanks @Anjelika for the feedback. I read a post earlier that said gastric sleeve was in the process of review & that as of the end of March (2012) it looked like they were going to finally approve it (by June-2012). Starting all my preparation & investigation now so hopefully Medicare will approve by the time I'm ready for surgery.

Just checked with Aetna Insurance (my supplemental medical insurance) and they said they cover weight loss surgery. Kind of ambiguous about whether or not the Gastric Sleeve is covered, but I've signed up for a couple of seminars so I'll ask the experts.

My primary care doctor said that she thought weight loss surgery would be an excellent step for me.

Medicare doesn't cover as of now' date=' but did you see if Aetna does?[/quote']

I spoke with Vanessa at Medicare yesterday & she said that Medicare does pay for weight loss surgery providing one meets certain health criteria: has a high BMI, has tried diets before, has no psychological problems, has health issues such as diabetes, high blood pressure, etc.

She even assisted me with the names of hospitals/clinics in my Zip code area that perform the surgeries. I'm calling Aetna today (supplemental insurance coverage to Medicare) to inquire about their coverage.

I've signed up for a 'Protein Tasting Party' to be put on by the Pacific Nutrition & Wellness Co. this coming Tuesday here in the Seattle area. Perhaps there are organizations in your respective areas doing the same. Then you can get taste samples of the Protein products out there. FYI.

I have had no trouble posting my avatar pic, but no matter what I do, I can't get a picture to post to the before category. I don't really have enough photos to create and album. I'd just like to get the picture to show in the before block. Can anyone help?

I'm by far not a computer genious, but I found that taking a photo with my cell phone then posting to my computer (desktop) is the simplest way to be able to download & forward pictures. Hope that helps. I've got to do the same.

Does anyone in the "Sixties Groupt" know if Medicare covers Vertical Sleeve surgery? I'm 65 and just now beginning to look into doing the surgery. I've been checking out all the various web sites and trying to get as much info as I can. I have a doctor's appointment this coming Monday (04/23/2012) and plan on starting the ball rolling by asking my primary care doctor about the process.

Good luck to those going in for surgery.

Congratulation on your journey forward. I'm still in the 'investigation mode' examining every bit of info I can get a hold of.

Of course the first step is determining if Medicare will pay for gastric sleeve surgery.

Please keep us informed of your progress.

I too was wondering if Medicare covers costs for sleeve surgery. I also have Aetna insurance as a supplemental. Does that matter?

Not certain if I'm askinging this question in the right forum, but haven't seen it posted elsewhere.

Is anyone familiar with Medicare covering VSG? I also have Aetna insurance as a supplement.How do the finances work out?

Thanks.

Hello to all & best of luck on upcoming surgeries. I'm new to this web site & new to the world of weight loss surgery. I'm still investigating all procedures & which one I feel will be the best for me. So far I'm leaning towards "sleeve" surgery.

I've been burning up the internet searching for any & all information pertaining to weight loss surgery, pre & post-op diets, best doctors in the area, etc.

I currently weigh 296-lbs. & am looking to get to my old fighting weight (figuratively speaking).