Rejoice! Medicare & Medicade Coverage For Vsg Is Currently Under Medical Review!

[mellifrits 25]

I think gingersnap lives in SC and is looking for the same advice.

Thank you I messaged her.

[Anjelika 14]

I just read this post... it should be good info for you and ginger if you decide to self pay...

http://www.verticalsleevetalk.com/topic/32644-800000-self-pay-in-the-us/

[gingersnap 11]

Thanks for the information reading Self Pay…looks like a great surgeon and a good deal. I'm really trying all my other options before I consider self pay.

[sdb1147 54]

I too was wondering if Medicare covers costs for sleeve surgery. I also have Aetna insurance as a supplemental. Does that matter?

[Anjelika 14]

I too was wondering if Medicare covers costs for sleeve surgery. I also have Aetna insurance as a supplemental. Does that matter?

Medicare doesn't cover as of now, but did you see if Aetna does?

[sdb1147 54]

Medicare doesn't cover as of now' date=' but did you see if Aetna does?[/quote']

I spoke with Vanessa at Medicare yesterday & she said that Medicare does pay for weight loss surgery providing one meets certain health criteria: has a high BMI, has tried diets before, has no psychological problems, has health issues such as diabetes, high blood pressure, etc.

She even assisted me with the names of hospitals/clinics in my Zip code area that perform the surgeries. I'm calling Aetna today (supplemental insurance coverage to Medicare) to inquire about their coverage.

[Anjelika 14]

Sdb,

Medicare does cover other weight loss surgeries, but not Vertical Sleeve Gastrectomy. That's the big daddy that everyone's waiting for.

[ProudGrammy 8,322]

she said that Medicare does pay for weight loss surgery

when i had my WLS,12/15/11 medicare did not accept the sleeve. so i luckily had a secondary ins. that did accept it fully.

i believe that the lapband & gastric bypass have been approved for quite a while.

i have heard from many on the board that the sleeve is not accepted yet - but they are in the process of continually looking at it, and hopefully will have a positive decision in a matter of months approving the sleeve

good luck to all w/medicare on the brain.

kathy

[sdb1147 54]

Just checked with Aetna Insurance (my supplemental medical insurance) and they said they cover weight loss surgery. Kind of ambiguous about whether or not the Gastric Sleeve is covered, but I've signed up for a couple of seminars so I'll ask the experts.

My primary care doctor said that she thought weight loss surgery would be an excellent step for me.

[Anjelika 14]

Ok, sdb originally asked if Medicare covered the "sleeve surgery". If by "sleeve surgery" you mean vertical sleeve gastrectomy, then no, Medicare does not cover it at this time. They do cover other WLSs. If you read this entire thread from the first post, then it will explain where Medicare is at in consideration of VSG.

[sdb1147 54]

Thanks @Anjelika for the feedback. I read a post earlier that said gastric sleeve was in the process of review & that as of the end of March (2012) it looked like they were going to finally approve it (by June-2012). Starting all my preparation & investigation now so hopefully Medicare will approve by the time I'm ready for surgery.

[Anjelika 14]

I hope they approve it as well! Good luck on your journey.

[sdb1147 54]

I hope they approve it as well! Good luck on your journey.

Me too! All this Medicare/Aetna insurance stuff is enough to drive one crazy. They speak in languages only they understand.

[Anjelika 14]

Me too! All this Medicare/Aetna insurance stuff is enough to drive one crazy. They speak in languages only they understand.

Majority of the times, I don't think my insurance reps even understand themselves. Lol

[sdb1147 54]

Majority of the times' date=' I don't think my insurance reps even understand themselves. Lol[/quote']

Attended another seminar for weight loss surgery last night. Was told up front that Medicare will NOT cover the sleeve procedure. They will however check with my supplemental coverage (Aetna) to see if they will. Oh, the forms to fill!