Getting Medicare To Pay

[empirejd 1]

My wife had her VSG in August and is doing well. She has been in contact with Medicare to get them to pay for her surgery. Based upon her request, Medicare did a study regarding the feasibility of the VSG for those on Medicare.

Their report came out last week and indicated that although the VSG is as safe or safer than the bypass, it could NOT be approved because any research done on the VSG utilized too small a sample size. I am requesting anyone who has had or is contemplating having a VSG and is on Medicare to contact Medicare with your outcome with the VSG

Medicare is seeking PUBLIC COMMENT regarding whether the VSG procedure should be approved. It could help future patients get the procedure approved by their insurance company if it's approved by Medicare. Medicare approval of the VSG could force private insurance companies to reevaluate their denial of the procedure and save lives.

The link to go to is long but if you go through it you should find a link for public comment. My wife and I have nothing to gain Forum members commenting. We only hope to spare others and their friends and relatives from the hassle we encountered.

Please read this and comment; http://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=258&ver=3&NcaName=Bariatric+Surgery+for+the+Treatment+of+Morbid+Obesity&TimeFrame=7&DocType=All&bc=AgAAYAAAIAAA&

Thanks again,

Larry (empirejd)

[Anjelika 14]

My wife had her VSG in August and is doing well. She has been in contact with Medicare to get them to pay for her surgery. Based upon her request, Medicare did a study regarding the feasibility of the VSG for those on Medicare.

Their report came out last week and indicated that although the VSG is as safe or safer than the bypass, it could NOT be approved because any research done on the VSG utilized too small a sample size. I am requesting anyone who has had or is contemplating having a VSG and is on Medicare to contact Medicare with your outcome with the VSG

Medicare is seeking PUBLIC COMMENT regarding whether the VSG procedure should be approved. It could help future patients get the procedure approved by their insurance company if it's approved by Medicare. Medicare approval of the VSG could force private insurance companies to reevaluate their denial of the procedure and save lives.

The link to go to is long but if you go through it you should find a link for public comment. My wife and I have nothing to gain Forum members commenting. We only hope to spare others and their friends and relatives from the hassle we encountered.

Please read this and comment; http://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=258&ver=3&NcaName=Bariatric+Surgery+for+the+Treatment+of+Morbid+Obesity&TimeFrame=7&DocType=All&bc=AgAAYAAAIAAA&

Thanks again,

Larry (empirejd)

Thank you, Larry, for being so pro-active in getting Medicare to approve VSG!

[gingersnap 11]

Thank you for your efforts and pointing us in the right direction. I am one of those people hoping that other insurance companies will approve the VSG. I think that it is a great surgery option!

[Kiwi/Nanci 9]

at 3pm today 6/27/2012 medicare approved the gastric sleeve...yeeeaaaahhhhhaaaaaaaaaaaaaaaaaaaaaaaaaaa

[Unobaby 5]

our u serious!!!!!!!!

[newme0617 6]

where is the info on Medicare paying for sleeve!

Is there a web site?

Thanks

[newme0617 6]

My doctors office said tha they had approved it....I had lap band removed due to an infection and she called to tell me that Medicare had approved the sleeve...but I have a catch 22...I lost enough weight to get to a BMI of 34.8....need a BMI of 35 with other medical issues...so she said I needed to gain to 205 from 196...so gain 9 pounds and come see us....are u kidding me...there has to be a provision in Medicare where if there is a reason that the surgery did not work, redo should not have to depend on a BMI as a factor of qualifying for the re do!

[Unobaby 5]

Heres the link for Medicare decision

http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=258&ver=2&NcaName=Bariatric+Surgery+for+the+Treatment+of+Morbid+Obesity&MEDCACId=26&IsPopup=y&bc=AAAAAAAAIBAA&