Called medicare...

[Jennyw 0]

I called medicare and the woman that i talked to said that as long as everything that i told her is accurate then i will be covered to get the surgery. I am so happy, i hope that the road ahead stays like this.

On a less happy note i weighed my self today and about cried...263

[Karon 1]

I called medicare and the woman that i talked to said that as long as everything that i told her is accurate then i will be covered to get the surgery. I am so happy, i hope that the road ahead stays like this.

On a less happy note i weighed my self today and about cried...263

Hi,

What did medicare tell you were their requirements? Just curious as I have an HMO Medicare program. i had to do a six months diet for one thing. I'm awaiting approval now. Don't stress over your weight, it will soon be a thing of the past. Are you just beginning your journey? My date is July 12.

K

[Jennyw 0]

well i am having to do the six ,onth diet, and i have a crap load of testing that i have to do. Heart lungs all kinds. I have to keep a food journal for six months.

[Wheelchair 13]

well i am having to do the six ,onth diet, and i have a crap load of testing that i have to do. Heart lungs all kinds. I have to keep a food journal for six months.

seriously?? are you sure those aren't your surgeon's requirements?

i have medicare and i was accepted by my surgeon immediately as i have a 35+ BMI and hypertension.

Medicare does NOT do prior-authorization so most surgeons try to be as stringent as possible before doing the surgery. Surgeons are supposed to charge the full amount to the patient beforehand, perform the surgery, and then receive 80% from Medicare (if they approve).

Depending on your surgeon's office, you may not have to pay upfront, as is the case for me.

Medicare itself only requires the 40+ BMI or 35+ w/ comorbidity, as long as the surgery is done at a center of excellence and with an approved surgeon.

[SageTracey 608]

Seems as though there is something to be said for the Australian health care system after all! Our medicare (govt) system has a simplified billing which doesn't require any pre-approval or even risk of rejection, so with my private health insurance, I was operated on within three weeks of seeing my surgeon for the first time, and only $1,000 out of pocket - total. Fills are bulk-billed i.e. fully covered by Medicare.

[CTMommy22 1]

I have medicaid through the state of ct, my insurance requires a pre-auth before they can book my surgery...

I have to do pulmonary, cardiology, pysch, and 6 x with a nutrionist, the dr submits all the info and they make their decision within 72 hours...

a long and frustraing process, but im sure it will help in the long run

[Barbyannn 0]

well i am having to do the six ,onth diet, and i have a crap load of testing that i have to do. Heart lungs all kinds. I have to keep a food journal for six months.

[Barbyannn 0]

I am going to an informational seminar about the Lap Band on Thursday. I am very excited. I have Medicare