WendyMay 13 Posted August 6, 2012 Hi everyone! I introduced myself in the wrong place, lol! So here I am. My name is Wendy and I am 42 years old. I am between 317 and 320 pounds right now. I don't have a surgery date yet, but I have a four hour appointment next Thursday, the 16th of August. I will be seeing the psychologist, the Nurse Practitioner, and the dietician. I am on Medicare and Medicaid, so I will probably have to lose between 25 and 30 pounds before I can have the surgery. I am really looking forward to this journey! Thanks for reading Share this post Link to post Share on other sites
cfmom716 8 Posted August 6, 2012 Medicare requirements are 6 months of weight checkins in the last 3 years by your primary care physician or any physician that has said you need to lose weight to benefit your health. Start searching for records from drs. you've been to in the last 3 years. They do not need to be consecutive. You need a Center of Excellance to get your surgery and for Medicare and Medicaid to approve. There is no amount of lbs. you need to lose just check-ins by dr. for weight. Must be medically necessary and you need a BMI of 40+. You'll meet that I did at about the same as you are now when I started the process. Be positive and active in the process to get this done and t will happen. Good Luck! Share this post Link to post Share on other sites
WendyMay 13 Posted August 6, 2012 Hi cfmom, I am not doubting you, but are you sure of that? I am going to a Center of Excellence. I have had the same PCP for 6 years or more. She wants me to have the surgery, and she weighs me once a month. I hope you are right about the Medicare thing. That would really make my day! Share this post Link to post Share on other sites
Jim1967 3,569 Posted August 6, 2012 Hi Wendy, Welcome to the forum and best of luck on your journey. I am from Salem, NH and go through the Center of Excellence through Lowell General. Good Luck on your journey Share this post Link to post Share on other sites
WendyMay 13 Posted August 6, 2012 Hi Jim. Thanks for the kind welcome and well-wishes! I am getting mine done through the Lahey Clinic Hospital Center of Excellence. Share this post Link to post Share on other sites
ddrobins 58 Posted August 6, 2012 Yea! Wendy! I'm so happy for you. Stay connected to this board. It's great for info , advice and encouragement.! Share this post Link to post Share on other sites
WendyMay 13 Posted August 6, 2012 Hi ddrobins! Thanks a lot! How long have you had your band? Share this post Link to post Share on other sites
cfmom716 8 Posted August 6, 2012 I am positive That's how it worked for me. As long as you can get 6 weigh ins in the last 3 years from a dr saying you needed to lose weight you are all set. If you have any conditions due to your weight it can help. Conditions such as: high blood pressure, gall bladder problems, breathing problems, joint problems, GERD, depression,high blood sugar, heart problems, even skin problems are all considered medical necessity. Or as I said a BMI of 40 or more without any conditions.You will also need from your PCP a letter of Medical Necessity. The necessary psych appt. , dr. clearance, you will need an EKG and bloodwork, xray. Share this post Link to post Share on other sites
WendyMay 13 Posted August 6, 2012 AWESOME! Thank you so much. Your help and info is very much appreciated. Share this post Link to post Share on other sites
WendyMay 13 Posted August 6, 2012 I got it! Thank you! Share this post Link to post Share on other sites
WendyMay 13 Posted August 6, 2012 Oops wrong post... hehehe. Share this post Link to post Share on other sites