Medicare

[MLR 0]

So my mother in law is pretty overweight and has a lot of the health problems associated with it (diabetes, high blood pressure, arthritis). She can barely even move around because she's in so much pain and I honestly believe that if she could get some of the weight off it would immensely improve her quality of life.

She said that her doctor wrote a letter to her insurance (medicare) saying that she should be approved for the lap band surgery and they wouldn't approve her. I was self-pay so I don't know anything about it. I have read on here about some people whose insurance companies tried to get them to go with gastric or something more drastic because they don't want to have to deal with the aftercare that comes with the band...

What I'm wondering though is if medicare ever approves the lapband surgery and how to go about getting approved. It's so important to my husband that his mom get healthier so that she'll be here and able to enjoy her grandchildren one day. So it's important to me to and I don't know if there's anything that I can do.

[MLR 0]

We're also in the Austin, TX area... I'm not sure if that matters... I really don't know anything about medicare

[MLR 0]

I've been sitting her trying to research this. True results in austin doesn't accept medicare... I don't know much about this... do you know if maybe she could get it done somewhere else in Houston maybe and then trueresults take her on as a patient for fills... grr... lol

[MelindaH 3]

Hi, as far as I know, medicare will approve the lap band if you meet certain criteria. I rarely use mine as I have it as a secondary. But I was told by my ins co-ordinator that will pay for it.

I sure there are a lot of hoops to jump through and that it has to be pre-authorized.

Go to www.medicare.gov and use the search thing and type in weight loss surgery and see what you get.

In the meantime, I will do some research of my own and post it if I can find it.

Good luck,

Melinda

[Corrigan 75]

Medicare is my primary and I have a secondary. The way it works in CA is you have the surgery

and then you find out if medicare will pay. In my case they did and with my secondary I think I'm

home free. I went to a Center of Excellence and they did all the billing and so far so good.

I called Medicare beforehand and the first time they said no, the second time they said yes,

so I went ahead and had the surgery, figuring I'd pay if they wouldn't. I wish I could give you a

better answer, but that's all I've got. I had diabetes an sleep apnea so that made it a little easier.

[MelindaH 3]

Medicare is my primary and I have a secondary. The way it works in CA is you have the surgery

and then you find out if medicare will pay. In my case they did and with my secondary I think I'm

home free. I went to a Center of Excellence and they did all the billing and so far so good.

I called Medicare beforehand and the first time they said no, the second time they said yes,

so I went ahead and had the surgery, figuring I'd pay if they wouldn't. I wish I could give you a

better answer, but that's all I've got. I had diabetes an sleep apnea so that made it a little easier.

Thanks for the reply, Corrigan. I went to the website and searched for thirty minutes and could not find anything.

Melinda