MEDICARE NOW COVERS SLEEVE GASTRECTOMY

[wtBgone 4]

I just received a Medicare notice that they now cover the gastric sleeve. Here is the link for their updated bariatric surgery policy:

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8028.pdf

[debiosbo 36]

that is so good I got approved 1/25/13 surgery 2/6 tomorrow at 11;30 I think they approved me earley because they knew medicare was going to change I have SecureHorizon/medicare and they wernt covering the sleeve either here in Oregon or Washington then finally they said yes I told my Dr office, they called the doctors line and were told no not covered yet I said send it in anyways and got approved in less than 24 hours

[SassySenior 111]

Thanks for starting this thread. I have been waiting forever to get wls surgery in Dallas, TX. I'm thrilled you got a notice where you live in Houston. Do you know if the same applies to Dallas? If not, I'll be going to Houston for sure!

[wtBgone 4]

This applies to all Medicare intermediaries (payers). Talk to the pre-authorization person at your surgeon's office and share the link with them if they are not familiar with the Medicare change. Good luck!

[SassySenior 111]

It's true that Medicare approved the sleeve, but left the decision as to whether to do it in the hands of regional contractors. I don't know if Dallas is in the same region as Houston. Do you know specifically that Houston is covering the sleeve?

I've seen info that something like 27 states are doing it, some are not, and others have put in more restrictions (re: age, etc.)

[Bebee 33]

Medicaid approved me Thursday.. I live n Louisiana...

[maggie914 20]

Anyone with Medicare getting stuck with having to pay?

[SassySenior 111]

Congratulations Beebee! You must be thrilled. Whenever I get the word, I know I'll be. Do you have a surgery date?

[Bebee 33]

Congratulations Beebee! You must be thrilled. Whenever I get the word' date=' I know I'll be. Do you have a surgery date?[/quote']

April 2nd

[wtBgone 4]

It would be best for everyone to contact thir medicare payer directly to determine coverage in their particular area. The notice I received was from CMS, which is the federal government "official Medicare." Google Medicare payer in [your state name] and you should be able to find the info you need.

[debiosbo 36]

I live in Washington had my surgery in Oregon and Medicare paid 2/6/2013

[SassySenior 111]

Congratulations to debisbo, how did it go?

I really appreciate hearing about individual states that have approved the sleeve. I'm sure my surgeon knows, but I'm afraid to call and hear anything but good news.

WBGone, I did the search, and it came up with varied results, including supplemental policies, which is very confusing to some, I would think. I did click on one of the links and got nowhere. More specific instructions help seniors like me get to the exact source. Thanks anyway.