Medicare/Medicaid in Oregon

[Lisa00 14]

Anyone know how long it takes to get an answer once it is submitted to the insurance company? I have medicare/medicaid so I am thinking it may take a long time to get approved for the sleeve. So anxious to here something.

[Bronco0605 135]

I have medicare. There is no insurance required waiting period if your BMI is over 40, mine was 48.something . There is no question the sleeve is covered if you meet the criteria for comorbities or BMI.

[Lisa00 14]

I have medicare. There is no insurance required waiting period if your BMI is over 40, mine was 48.something . There is no question the sleeve is covered if you meet the criteria for comorbities or BMI.

I have a BMI of 40 and Diabetes type 2 and many other comorbities, so I am hoping it won't be long.

[NewAshes 232]

I live in Oregon and have the Oregon health plan plus (trillium) they had a 6 month supervised diet then it took 1 week for aaproval.

[Bronco0605 135]

I had to wait a lot longer to fulfill the requirements of the weight management program than I did for medicare! I started with the physical for weight management on June 25 and could have had surgery in mid October. I had to have lots of tests and appointments and classes in between. I am sure you will too.

[Lisa00 14]

What does a 6 month supervised diet consist of?

[NewAshes 232]

It really depends. My nutritionist had me start taking two Multi Vitamins a day. Stop drinking pop and juice and caffeine I don't drink coffee but I did drink tea with sugar and caffeine in it. She had me work on not eating bread. I was required to lose 20 pounds by my surgeon as well.

[Bronco0605 135]

Medicare does not require a six month supervised diet.

[Lisa00 14]

I am not just on medicare but medicaid as well, not the Oregon Health Plan, it is just Oregon standard open card. So what ever medicare doesn't pay for medicaid will pay the rest is my understanding.

[SuperFab 689]

I am not just on medicare but medicaid as well, not the Oregon Health Plan, it is just Oregon standard open card. So what ever medicare doesn't pay for medicaid will pay the rest is my understanding.

That's how it is for me, in Oklahoma.

[Lisa00 14]

Hi all, just wanted to let everyone know, I got APPROVED for surgery for the sleeve. I have my first of many appointments on Feb 4th. I am nervous yet excited. YEAH!!

[fit2Bme2014 38]

I have medicare. There is no insurance required waiting period if your BMI is over 40, mine was 48.something . There is no question the sleeve is covered if you meet the criteria for comorbities or BMI.

OH!! Now I understand. My dr. office called last week to reschedule my first appointment with the surgeon, and to tell me that my surgeon will be leaving the practice in a few months, but because of my insurance, I don't have to weight the usual "6 month" weight period, so I could probably have the surgery before she leaves if I wanted to. I was to overwhelmed to ask what she was talking about, but now I understand. I have Medicare and a bmi of over 50. How did this happen. I can't believe that I've regained 50 over the last year. Self-loathing... I can lose weight. I've don't it before. I just can't seem to keep it off...