Ny Waiting For Medicare Approval

[Alexandra39 72]

Hi,

Has anyone heard if Medicare is approving VSG in NY? I heard the final decision would be made today. It didn't look good last time I called from what they said about the previous review. It's so frustrating that they accept it in other states but not here. You'd think NY would be one of the first places to have it approved. I am afraid to call...but I will sum up the courage to do so... I hope it's approved! I'll be done with my 6 month paperwork next month so I'm ready!

[Ms skinniness 3,003]

Keeping my fingers crossed for you!

[Unobaby 5]

Im in Ohio and I'm also waiting to see what medicare decision Im keeping my fingers crossed to.

[mokee 588]

I'm also in ohio and just talked to 3 different people in the Medicare office. No one knows anything. I have other insurance that will cover it but Medicare comes first. I can not even get a denial letter from Medicare which is what I need for the other insurance. The surgery has to be over for them to deny it. And then since I could not get a denial the other insurance may not pay because I couldn't get a pre cert. I can't be stuck with such a bill.

[babygirl_sandy 85]

I'm here in Pennsylvania waiting for this decision to be official, I read in another post that they had more than enough research and patient input to make a positive decision.. Fingers and heart crossed..

Sent from my SPH-D710 using VST

[Kiwi/Nanci 9]

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

[gingersnap 11]

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

Where can we read about it, I'm looking for the information to review.

Thanks!

[newme0617 6]

me too..cannot info on web

[lovex5 25]

I just read it, how exciting! Now, come on Tricare!!

[newme0617 6]

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&

APPROVAL!!!!!!!!!!!!

[njsleeve 142]

Good luck my fingers are cross

[mokee 588]

Waiting in NY!!!! Does this article mean it was approved everywhere for Medicare? Just talked to my doctors insurance guy today and he was not even awhere. Hope what I am reading is true. Best of luck to you and thank you for the info.

[Alexandra39 72]

I called my surgeon's insurance coordinator yesterday at about 3:20 pm or so and she told me that Medicare did not approve I had spoken to my Primary Care Physician (the same doctor to referred me to this surgeon for Lap Ban Surgery) and he and I basically thought that if Medicare denied this time around it would take a while before they reviewed the VSG again. I actually want the Laporoscopic VSG, as a stand along surgery. After the initial talks with my PCP, I did my research and I thought the VSG would be the best option for me. First of all, it is a more aggresive approach I need to lose about 100 pounds. I am 5 foot 1 inch and currently weigh 217. Second, I think it is much more "doable" for me. I tend to get cravings for sweets often and I think the fact that this surgery removes the part of the stomach that produces the hormones linked to hunger and cravings is great! I also am a little hesitant about the idea of having something foreign placed inside me. My doctor whom I trust has reassured me that the Lap Band is safe and the surgeon who he recommended is among the top surgeons in the country. That is the only reason I would consider it.

I lost 7 pounds last month but was not able to lose any weight this month. My daughter had some health issues and it just through me off my focus on my eating habits and I had stopped keeping my food diary on Fitness Pal. I actually thought I had gained weight but was pleasantly surprised (more like relieved) that I did not. For the first time, my pressure was normal at this visit. I am taking pressure medication and aspiring though. I also don't drink as much soda as I used; I drink more Water so I am sure that helps a lot.

Anyway, getting back to the insurance issue...Does anyone from New York know what the deal is? I read the info on the link and it does sound like it is up to the surgeon to make the call. When I first visited the surgeon, I went in to consult what she thought would be the best option for me; Lap Band or VSG. After asking me some questions about my medical history, she suggested I go for the VSG even though she specializes in Lap Band. She believed that the number of medicines I take and the size of some these pills would not be possible for me to take given the fact that with Lap Band you cannot swallow anything larger than the size of a tic tac. I also think she took into account my BMI which is quite high and she thought it VSG would allow me to lose the most weight. I trust her with either surgery but like I mentioned before, I do prefer the VSG because I believe it is the best choice for me.

I think I will call Medicare myself today to ask and will also call the surgeon's insurance coordinator depending on what I hear from Medicare. If anyone here in NY has any info about the decision for NY...please let me know. Good Luck to everyone who is waiting...hang in there, I know it's not easy...To those who replied a big thank you and I am aso keeping my finger crossed for you all.

[babygirl_sandy 85]

Just got off the phone with medicare and they have no idea what report i was talking about and when i told her i downloaded it from their web site she acted like she was confused. So I really am confused as to what this report states and to what the actual medicare knows and are willing to tell us over the phone.. My surgeons staff seemed like she was annoyed at the fact that i was calling this morning for more information, then proceeded to call me back to tell me that she has contacted medicare and that they said it was not covered.. So can someone tell me who's stating the truth???

very frustrated!!

[Alexandra39 72]

I am going to call. I am almost afraid to. Same feeling with my surgeon's Insurance coordinator. I feel like I am annoying her if I keep calling when she already told me it did not approved. This is really frustrating. Also, the fact that there is a lot of confusion because it is a state by state thing. I did make an appointment with the surgeon anyway for July 6th. So even if they don't know, I figure they'll be sure by then. I hate this waiting.