Medicare:Anyone Ever Denied?

[NeenBand 7]

On Monday I go in for my psch eval and nutritionist visit. Which is costing me around $500 out of pocket.

I just had a thought come to me, I don't know if Medicare will be approving this!! I didn't even think to ask as I assumed they would. But now I am hearing about others denied!!

Beyond the fact that I will be losing all that money (which is food and rent money for me) the thought tha this won't happen for me is devastating.:faint:

Thoughts?

[Alexandra 55]

Eileen, I just heard once again at a preop seminar this week that Medicare never denies for this surgery as long as it's medically necessary. As the insurance coordinator says, "it's the one thing Medicare does RIGHT."

So if you're going with Advanced Laparoscopic, I know they are confident that Medicare pays for bariatric surgery.

[NeenBand 7]

What a relief!

Alex...I hope you feel this hug through the computer screen! :-)

Even though my BMI is on the lower side, so I hope Medicare finds it necessary. I know I do. Do you happen to know what they might deem necessary? I have asthma, high cholestral, GERD,Fibromyalgia and Imay have sleep apnea.

[chichigirl 1]

Just thought I might mention, that late in the year of 2005, they were voting as to whether or not to approve folks beyond the age of 65 years of age or not for WLS. I don't know what their final decision was, nor do I know your age, not being nosy, just letting you know they were thinking about the age cut off.

I had Medicare with a supplemental when I had my surgery done in 2002, and was denied at first, but once they listed all of my co-morbidities, which were a mile long, they finally agreed. The asthma, fibromyalgia and the high cholesterol might be sufficient for you to be approved.

I wish you the best of luck, please let us know how things are going.

Cindy

[NeenBand 7]

I hope so too. Thank you for the support and well wishing.

I'm 42. I think perhaps going over all my health issues before submitting would be the best thing. WHo do I do that with? The surgeon or the insurance co ordinator?

[Alexandra 55]

Don't worry; the doctor and the insurance coordinator will both be collecting all your health issues in your file. You'll be talking about everything at your consultation, and the doctor will note the pertinent details for the insurance coordinator.

They're very good at what they do. They won't let any details pass by.

[NeenBand 7]

Thanks again Alex.

I think it's so cool that we have the same surgeon. Makes support that much better