Hi, I'm a newbie here and have a couple ?s

nanahanna · December 27, 2005

Hi ya'll. I am 61 years old, have diabetes (oral meds)for at least 5 years, psoriatic arthritis (on methotrexate)diagnosed 3 years ago, and have been diagnosed with high blood pressure since last fall and am on meds for that. I also have diverticulitis. I have had so many doctors visits I am just about sick of it. BUT....I really need to lose about 80 pounds. I know it would help my diabetes and my arthritis, but I can't seem to do it. I have had weight problems since I stopped smoking when I was 41 years old. My weight has gradually climbed from 135 to 225 in those years with diets interspersed where I would lose weight then regain it quickly after stopping the diet. On to my questions:

I am still covered by my husband's insurance (I am receiving disability from Social Security for the past two years) and will be eligible for Medicare in April or May. SS says they will automatically put me on Medicare when I meet the 24 month timeline. That will be April or May ...not sure which. My primary insurance with remain my husband's through his work which is BCBS of Mississippi. They expressly and adamantly say they will not approve any weight loss surgery or medications. so....

do any of you know if Medicare will pay for the lap band surgery?

Thanks for any info in advance! Glad to find ya'll!

Nanahanna

Alexandra · December 28, 2005

Medicare does cover obesity surgery for those who qualify medically, and has covered banding. But they don't pre-certify, so you need to work closely with your doctor to be sure all the medical points are in order. It must be medically necessary for Medicare to cover.

nanahanna · December 28, 2005

Thanks Alexandra. Do you mean work closely with my personal doctor or do I go ahead and make and appointment with a surgeon? Is there anything I can do up front to get things going?

Nanahanna

Alexandra · December 28, 2005

The place to start with this is with your primary doctor, who will give you a complete physical. Then find a surgeon and make an appointment. The surgeon will have lots of questions and paperwork for you to complete, and he will be the one to ultimately deal with your insurance carrier. You may have a bit of trouble finding a bariatric surgeon who accepts Medicare, I don't know.