MrsKitKat 1 Posted December 27, 2012 Has anyone used Medicare for WLS? If so, what were the requirements? I have Medicare with BCBS Federal as a secondary. I was told I need to take a 3mth medicare weightloss class through my surgeons office. Is anyone else familar with this class? Share this post Link to post Share on other sites
mrsb12 73 Posted February 10, 2013 WHERE DO YOU LIVE? DOESN'T TAKE THAT LONG, I'M IN FL AND ONLY HAVE MEDICARE A&B , LORD HELP ME WHEN I GET MY 3 DAYS STAY AT HOSPITAL AND DOCTOR BILLS NOT ENTIRELY XOVERED BY MEDICARE ....all you really need is primary care doc to recommend you for surgery, blood test , a BMI of 30 or more with diabetes, high blood pressure or sleep apnea ,psychologist clearance chest xray ,pylori breath test ,nutritionist clearance and you should be ready to go ..hope it was helpful , Medicare has the info online or google Medicare requirements for wls or gastric bypass there are a few sites with good accurate information ,good luck, hope it helps Share this post Link to post Share on other sites
padlrd 183 Posted February 10, 2013 I didn't have to do any classes are anything for Medicare to approve my surgery Share this post Link to post Share on other sites
padlrd 183 Posted February 10, 2013 I just made appointment with Gastric dr and he got it approved in just a day and I had to do the same as the other post above but I think that's standard for everyone Share this post Link to post Share on other sites
DebbieG 262 Posted February 28, 2013 I had to do a 3 month with nutritionist, get clearance from primary doc, cardiologist, cardiac stress test, an ultrasound of gallbladder, psych evaluation, 5 yrs of weight documentation, go to 2 weight loss support groups before submitting to ins. - Monday we submit to ins. Co. I'm so excited!! Hope its a quick response. Crossing fingers. Share this post Link to post Share on other sites
mrsb12 73 Posted March 3, 2013 I had to do a 3 month with nutritionist' date=' get clearance from primary doc, cardiologist, cardiac stress test, an ultrasound of gallbladder, psych evaluation, 5 yrs of weight documentation, go to 2 weight loss support groups before submitting to ins. - Monday we submit to ins. Co. I'm so excited!! Hope its a quick response. Crossing fingers.[/quote'] With Medicare ? What was your BMI and health conditions? Mine was 54 and sleep apnea and I got approved as soon as I asked my doctor....good luck living4myself_gb1-21-13: Share this post Link to post Share on other sites
DebbieG 262 Posted March 3, 2013 I'm in RI, So its a Medicare / United Health Care/Rite Care. My starting weight is 258 a BMI of 46. I had a left kidney removal in 2010. We are submitting to ins. Co on Monday after my last 3'rd Nutrition appt. Share this post Link to post Share on other sites
DebbieG 262 Posted March 3, 2013 Thanks for the good luck! I hope I get a quick response from ins co. Share this post Link to post Share on other sites
gravesmisty69 6 Posted September 25, 2014 WHERE DO YOU LIVE? DOESN'T TAKE THAT LONG, I'M IN FL AND ONLY HAVE MEDICARE A&B , LORD HELP ME WHEN I GET MY 3 DAYS STAY AT HOSPITAL AND DOCTOR BILLS NOT ENTIRELY XOVERED BY MEDICARE ....all you really need is primary care doc to recommend you for surgery, blood test , a BMI of 30 or more with diabetes, high blood pressure or sleep apnea ,psychologist clearance chest xray ,pylori breath test ,nutritionist clearance and you should be ready to go ..hope it was helpful , Medicare has the info online or google Medicare requirements for wls or gastric bypass there are a few sites with good accurate information ,good luck, hope it helpsHave you had yours done yet? I have medicare a&b and Medicaid I am hoping they pick up the rest of my 20% and my deductible for my hospital stay that is 1216 dollars. What did you end up paying and did you have to pay before the surgery I am so stressed I see my surgeon on the 30th but I am trying to find out as much as I can to try to ease my mind. Share this post Link to post Share on other sites
wildGoose 207 Posted September 30, 2014 Medicare varies from state to state. For instance, I'm in California. Here Medicare does not pay for a Sleeve Gastrectomy but pays for RNY/Gastric Bypass. On the other hand, the requirements are "easier" to the point where if you meet the requirements of the Center for Excellence, you are there. Share this post Link to post Share on other sites
Jersrose43 837 Posted September 30, 2014 Medicare varies from state to state. For instance, I'm in California. Here Medicare does not pay for a Sleeve Gastrectomy but pays for RNY/Gastric Bypass. On the other hand, the requirements are "easier" to the point where if you meet the requirements of the Center for Excellence, you are there. Medicare is a federal program and does not very from state to state Medicaid is a program run by individual states and the rules very widely from state to state Share this post Link to post Share on other sites