I don't have Medicare, but I know someone who does and was banded at some place in Detroit, MI. As far as I know she had to have some testing done before hand (not sure what) but I know she didn't need a letter documenting her weightloss journey. I think she needed a letter from her doctor saying that it was medically necessary, and some other stuff. I do know that once she had all her paperwork in, she had her band done within a month. From what I read, thats awesome. I can find out more from her if any one would like.