Why does Medicare make you wait?

[meyouus 415]

I was wondering why Medicare makes you wait six months for the surgery.

[oldoneyoungagain 200]

I was wondering why Medicare makes you wait six months for the surgery.

I am on Medicare but I had the option to go with other insurance to cover my hopitalization and part B & D, rather than going with straight CMS which is medicare. It was I either pay to Uncle Sam or sign up with a Medicare approved company, still costing the same. In my case I went with Hummana Gold Plus. I went from having my lapband out in May, started everything they required under Medicare and had bypass 10 weeks later. I didn't have to wait six months. I did though with the lapband have to wait six months with my employer's insurance Blue Cross Blue Shield of Rhode Island. Sorry you are having to go through all that.

[M.A. Cruz 15]

I had my Lapband done in 2006 with Medicaid (NJ) and I guess I was one of the very lucky ones that didn't have to wait much. From the first pone call with the doctors office to the day of surgery was only 3 months with all specialists and requirements in between.

[SoccerMomma73 1,867]

I was wondering why Medicare makes you wait six months for the surgery.

Most insurances have some waiting period....I think there are multiple reasons. Some hope you'll give up and they won't have to ay for surgery. Some truly want to make sure you are educated on what you are about to do so you'll have the best possible outcome.

From a medical standpoint, I can say a lot of people approach this with little to no knowledge about the surgery or post-op lifestyle changes. I've seen people eating steak a week post-op. I've seen someone die weeks post-op essentially because of gorging herself. While I personally view this surgery as being just short of magical, there's still a lot of work that has to be put in to being an RNY success story. Waiting sucks, but knowledge is necessary for success!

HW 312, pre-op (RNY) 255, current weight 199

[meyouus 415]

I am only in the research stage of having this RNY surgery. I found the LBT page 5 years after my Band and it still offered me much needed information (and some friends too!). I just heard that Medicare customers such as myself, had to wait six months. When I did the Band in 07, the process was quick, too quick IMO. I was not prepared for the changes to come. I ask a lot of questions now so I don't make the same mistake with RNY, though many of the Band lifestyle changes do apply with RNY. * I just wondered what lay behind the reason for specifically SIX months. Or if there even was a six month wait. My LapBand was paid for by Medicare, but I was still stuck with a hefty bill. In my planning, I need to know about the wait, the cost, etc. * And I need to find a workable, realistic means to deal with my emotional and clinical addiction to food/eating other than OA (no comment) or my current therapist/psychiatrist. She is helping me deal with some really heavy stuff that shouldn't be neglected and I've tried many times to tackle the addiction issue, but she doesn't really understand it. She tries. So I need time to pull that together anyway before I'm under the knife. * I'm calling my Surgeon's office tomorrow to make an appointment to discuss how HIS journey with his RNY program goes. I'll overthink it, then come on here and ask MORE questions! * oldone, I have Medicare Parts AB and D. I cannot afford to pay for extra insurance, no matter how I spin it. When I had my knee's replaced, there was some sort of program I applied for at the hospital that poverty zone which took off a massive chunk of the cost. Forget what it's called, I just hope I can do it again with this RNY. * Thank you guys for offering your two cents!

[RhondaWilliams 66]

I was wondering why Medicare makes you wait six months for the surgery.

I have BCBS and waited 6 months... It was exactly what I needed... I had numerous appointments/paperwork to complete but was mentally ready to change my life!

[pear425 32]

Most all surgeons and insurance now require a 6 month supervised diet program. In this time you should be attending education for pre and post op topics. They aren't just making you wait to wait. You have to work with a nut or PCP and have it documented.

[M.A. Cruz 15]

I am only in the research stage of having this RNY surgery. I found the LBT page 5 years after my Band and it still offered me much needed information (and some friends too!). I just heard that Medicare customers such as myself' date=' had to wait six months. When I did the Band in 07, the process was quick, too quick IMO. I was not prepared for the changes to come. I ask a lot of questions now so I don't make the same mistake with RNY, though many of the Band lifestyle changes do apply with RNY. * I just wondered what lay behind the reason for specifically SIX months. Or if there even was a six month wait. My LapBand was paid for by Medicare, but I was still stuck with a hefty bill. In my planning, I need to know about the wait, the cost, etc. * And I need to find a workable, realistic means to deal with my emotional and clinical addiction to food/eating other than OA (no comment) or my current therapist/psychiatrist. She is helping me deal with some really heavy stuff that shouldn't be neglected and I've tried many times to tackle the addiction issue, but she doesn't really understand it. She tries. So I need time to pull that together anyway before I'm under the knife. * I'm calling my Surgeon's office tomorrow to make an appointment to discuss how HIS journey with his RNY program goes. I'll overthink it, then come on here and ask MORE questions! * oldone, I have Medicare Parts AB and D. I cannot afford to pay for extra insurance, no matter how I spin it. When I had my knee's replaced, there was some sort of program I applied for at the hospital that poverty zone which took off a massive chunk of the cost. Forget what it's called, I just hope I can do it again with this RNY. * Thank you guys for offering your two cents![/quote']

Charity Care

[oldoneyoungagain 200]

I am on Medicare since I'm 71 as of June 1 of this year and only had to do three months. And it was approved within two business days from date of submission.

[meyouus 415]

Charity Care

Thank you! "Poverty Zone" was all I could muster.

[oldoneyoungagain 200]

* oldone, I have Medicare Parts AB and D. I cannot afford to pay for extra insurance, no matter how I spin it. When I had my knee's replaced, there was some sort of program I applied for at the hospital that poverty zone which took off a massive chunk of the cost. Forget what it's called, I just hope I can do it again with this RNY. * Thank you guys for offering your two cents!

I think you misunderstood, I pay the same amount as you do for Medicare part B (part A is free) and part D. Rather than the money going into Uncle Sam's hands, I elected to sign up for one of the insurance's offered in my state (they are located in the back of your "Medicare & You" book, just received my 2014) thus for me it was Humana Gold Plus. These insurances also have to follow Medicare guidelines.

[meyouus 415]

I think you misunderstood, I pay the same amount as you do for Medicare part B (part A is free) and part D. Rather than the money going into Uncle Sam's hands, I elected to sign up for one of the insurance's offered in my state (they are located in the back of your "Medicare & You" book, just received my 2014) thus for me it was Humana Gold Plus. These insurances also have to follow Medicare guidelines.

I don't understand the whole thing. I saw the insurances in the book and what I get from it is, you keep your Medicare and if you want to pay for supplemental insurance, like BCBS, you can. Is that what you mean? I'm foregoing Humana this year, I payed in more than I saved, didn't make sense.

[oldoneyoungagain 200]

I don't understand the whole thing. I saw the insurances in the book and what I get from it is, you keep your Medicare and if you want to pay for supplemental insurance, like BCBS, you can. Is that what you mean? I'm foregoing Humana this year, I payed in more than I saved, didn't make sense.

Whether you take those insurances or not, unless you're on Medicaid also, you will still have to pay for Part B and D, it doesn't come free. The only thing you don't have to pay for is Part A which is the hospitalization. Part B is your doctors, labs, xrays, medical equipment etc and D of course is the drugs. And no you do not keep your Medicare when you take these insurances, but in order to have coverage for B & D you still have to either pay it to CMS which is medicare and also your prescriptions benefits or to someone like Humana, either way it doesn't cost anymore. The only time I would have to pay more is if I took out gap insurance, which would then pay my deductible and the balance of the 20% owed through part B. I actually had coverage under my employer, when I finally enrolled in part B and because I had other coverage I couldn't enroll in something like Humana, but CMS still took $104.40 out of my SS check. I dropped my employers insurance on May 31 because they doubled the premiums and next year, because of age, I wouldn't be able to be covered under them. Think you should check with Medicare.