Medicare/humana

[kjntwins 59]

I am 30 years old, and will be eligible for medicare/humana on May 1st. I am really hoping for the sleeve. But I can't find the info on medicare/humana approval

[atkinsoncl 62]

I do not have that insurance, but if you call they should be able to give you the specifics. They might not be able to give you an answer until you get the insurance, but it doesn't hurt to try now. Good Luck!!

[ProudGrammy 8,322]

hi kjnt

the good news - i've heard that medicare is in the process of thinking strongly the credentials for the sleeve, and i hear they might accept the sleeve shortly/eventually!! Thats only hearsay, but look into, stranger things have happened.

I don't know what medicare/human is? sorry

when i applied for sthe sleeve in november - it was explained to me that Medicare does not accept the sleeve, no if's and or buts - so the procedure to get approved is this ......

you have to go into surgery kind of blind folded - your hospital will send bill after surgery to Medicare, (can't do it before surgery for some rules by medicare- who then will officially deny surgery for after the required 30 days.

then the bill has to be returned to hospital - where hospital will proceed to send bill to your secondary insurance (if you have) luckily i do have BCBS from my old employers. Then the sleeve will be officially accepted, if you meet all the required morbities and BMI.. Sounds like congress approving a bill?!

I did have long discussions with BCBS prior to WLS who said i was unofficially approved, they were pretty sure... but nothing was in paper. so i went on with my surgery

my WLS was 12/15/11 - and i was officially totally approved 2 months later!!

long story, but tru - hope i explained it right - actually, sadly true

kathy

good luck

[kjntwins 59]

I will have medicare and then Humana as my supplement insurance. But all my research it showing that Humana does not cover the VSG due to being "new" I speak with my insurance agent on Wed. I just want to be informed on different type of medicare supplement insurance. They cover lap band, and the bypass. I just want the sleeve done.

[atkinsoncl 62]

My insurance did not cover the sleeve, but I decided to go on with my three month required session anyway. Although I wanted the sleeve, I was going to get the lap band for insurance reasons. I started my process late November and in January, the sleeve was now an option for surgery. I was so happy when the surgeon told me the news. More and more insurance companies are approving the sleeve now. Hopefully, your's will not be too far along.

[kjntwins 59]

Great news! I went in to speak to the surgeon about gastric bypass, b/c my insurance would not cover the sleeve. I have Humana Gold which is the supplement for medicare. The dr confirmed that I could not have the bypass due to medications I am on. But he mention that my insurance does pay for the sleeve. I still didn't believe him since I call the insurance company two weeks ago. I called them again today, and they do COVER the sleeve. I have too meet a lot of criteria, but I am so excited!!

[atkinsoncl 62]

That's great!! Congratulations!! I, too, was so exstatic when I was told that the sleeve was now covered. Woohoo for you!

[emptynesterpam 13]

My insurance did not cover the sleeve' date=' but I decided to go on with my three month required session anyway. Although I wanted the sleeve, I was going to get the lap band for insurance reasons. I started my process late November and in January, the sleeve was now an option for surgery. I was so happy when the surgeon told me the news. More and more insurance companies are approving the sleeve now. Hopefully, your's will not be too far along.[/quote']

Hello, have any of you heard that high cholesterol may not be a qualifying diagnosis for the co- morbidity?

[atkinsoncl 62]

Hello, have any of you heard that high cholesterol may not be a qualifying diagnosis for the co- morbidity?

Yes, my insurance does not consider high cholesterol a qualifying diagnosis.

[keya34 46]

Hi I also have humana gold choice and am currently try to get approved. My bmi is 49 and I am 5'5 not including shoes lol. But really i just want to know how hard is it to get approved? I have no comorbity and I dont want any I want to just be healthy and take my life back. Now i do have more test to check for arthritis and I have Fluid on my spine my L5 area. Will this help me?