medicare

[reallyrosy 161]

I'm convinced I have to self pay for VSG because medicare will not issue pre approvals. the doctors don't think they will get paid.

Has anyone within the last few months of this year been successful in obtaining medicare coverage.? Where are you located and how long did it take ?

Thank you

[gracemarie 6]

I'm convinced I have to self pay for VSG because medicare will not issue pre approvals. the doctors don't think they will get paid.

Has anyone within the last few months of this year been successful in obtaining medicare coverage.? Where are you located and how long did it take ?

Thank you

Sorry to have to tell you this but Medicare is Federal and rules apply to every state. I too found out Medicare does not pay as I am 65. Luckily for me my husband is a physician and his hospital gives 50% discounts to docs and family for non covered procedures.

[reallyrosy 161]

Thanks for confirming.

[BettyBoop 28]

I'm convinced I have to self pay for VSG because medicare will not issue pre approvals. the doctors don't think they will get paid.

Has anyone within the last few months of this year been successful in obtaining medicare coverage.? Where are you located and how long did it take ?

Thank you

Hello,

I am disabled and on Medicare and they are paying for my Gastric Sleeve surgery. Although I do have Kaiser Permanente Senior Advantage. ( I am not a senior tho) Rather than plain Medicare.

I'm having my surgery at the end of this month.

[reallyrosy 161]

I'm in awe of your success. I wonder if the disability has anything to do with the approval. I have a secondary insurance tht tells me I am approved and if I call medicare, they say I am approved but once the docs and hosps etc get into it, according to them, medicare says I am not approved.

My head is spinning . Will see surgeon in nov. Still waiting for bill quote from hosp. Good luck to you!

[BettyBoop 28]

I'm in awe of your success. I wonder if the disability has anything to do with the approval. I have a secondary insurance tht tells me I am approved and if I call medicare, they say I am approved but once the docs and hosps etc get into it, according to them, medicare says I am not approved.

My head is spinning . Will see surgeon in nov. Still waiting for bill quote from hosp. Good luck to you!

Thanks so much reallyrosy!!

I don't think my disability has anything to do with it. I think it is because I have Medicare's "Advantage Plan". I do not pay extra to have an Advantage Plan through Kaiser.

Perhaps if I had just regular Medicare, they wouldn't pay for it?

Just a thought. But could you join an Advantage Plan? ( when you're allowed to change ) I know there are certain times you can change to an Advantage Plan. Maybe look into that??! It would take some time, but at least you wouldn't have to pay out of pocket.

Good luck to you!

[BettyBoop 28]

Here is some more info I gathered by doing a google search. Apparently if you have just plain Medicare, the sleeve is not covered. If you belong to a Medicare Advantage Plan, it maybe covered if the Insurance company itself covers the sleeve!

Here is so great info. It is off of another WLS forum. I hope the administrators here don't mind me posting this. If they do, they are free to remove it. Just trying to help people find the answers they need.

http://www.obesityhelp.com/forums/vsg/4288196/Medicare-DOES-cover-VSG-under-quotsomequot-privatley/#35508730

[reallyrosy 161]

Like I said, I have special coverage from bcbs anthem from my state. If it is pre authoized /certified, they will cover even if medicare refuses. So I need to explain this to the provider. Wish me luck

[BettyBoop 28]

Like I said, I have special coverage from bcbs anthem from my state. If it is pre authoized /certified, they will cover even if medicare refuses. So I need to explain this to the provider. Wish me luck

Sounds great !!! Good Luck!!!