I have gotten Medicare to reconsider accepting the Sleeve Gastrectomy. you need to view the psoting. They are soliciting public comments.
http://www.cms.gov/medicare-coverage-database/details/nca-details.aspx?NCAld+=258&ver=2&NcaName=Bariatric+Surgery+for+the+treatment+of+Morbid+Obesity+(2nd+Recon)&bc=ACAAAAAAAAAA
Please visit this site and post any information in favor. Thanks.
Marcia
name='likasulema' timestamp='1318798760' post='219248']
i have medicare as my primary coverage, but empire blue cross as my secondary. MEDICARE does NOT cover the sleeve yet because its relatively new (few years or something. ) Medicare DOES cover the lapband and gastric bypass. (but i want the sleeve)
My surgery for the sleeve is 12/7 - medicare will send the "official" denial for the sleeve after hospital sends bill, empire needs to see the "official" denial first, and then empire looks at my qualifications in having the sleeve. I have all the qual.. (BMI, diabetes, high chlolesteral, and high blood pressure, and sleep apnea (aren't I lucky???!!!)
The insurance companies know that Medicare doesn't cover the sleeve, but they need the official denial after the surgery. Then the other insurance company can proceed. I know this sounds weird, its the beurocracy (msp) but thats how it was explained to me. Empire does cover the sleeve - so they told me after all the paperwork is sent in I will be 99% positive I will be approved. They can't officially guarantee it for obvious reasons. But they did tell me unofficially of course that everything looks fine.
so the bottom line is MEDICARE doesn't cover the sleeve, no if ands or butts, but your secondary might cover it, like my empire blue cross.
hope i've helped - without confusing you too much - write back w/any more questions )