MEDICARE/MEDICAID

[bravobentley 55]

Has anyone gotten approved with medicare insurance I have medicare and medicaid but was told medicare would be my primary! Just wondering how long it took to become approved using medicare? I have my first appointment with the surgeon this thursday I also need questions to ask him... any suggestions would be greatly appreciated

sammy

[jtickle 295]

I have Medicare, you have to jump thru hoops with them just like regular insurance. They require the 6 month diet, bariatric center of excellence and so on. My husband's insurance doesn't have any requirements, so I am not even going to use my Medicare.

[onestepforward 0]

I think because of our budget problems, medicad won't cover the surgery anymore. So that leaves me with Medicare only. I haven't called them yet, but the doctor didn't seem to indicate that it would be a problem to get approved. I guess my question is if anyone could share their share of costs experience with Medicare. I'm not sure I can afford the surgery because it's so expensive, especially when you include all the preop work that needs to be done. Any infor on how to find extra funding would also be much appreciated.

[jtickle 295]

Medicare pays 80% of WLS. You have to do a six month diet. You also have to meet some other criteria. All you will have to pay is 20%.

[schoollass 11]

I worked with medicaid, not medicare. Get ready to jump through alot of hoops and get on a first name basis with your case manager. I filled out the paper work for my surgeon that included listing every way I had ever tried to lose weight, then tried dieting for them, went through the psych eval which is standard before surgery, got a referral from every doctor I had ever seen in my life(my primary from when I was a child, my current primary, my back doctor, my ortho for my knees, my GI, etc.), filled out an extensive medical history not only for myself, but a familial medical history that showed the morbidities I would get if stayed at 365 or continued to gain weight. In other words, it was a battle, but well worth it. It took about 18 months to get approved and by then I had been through all the nutrition classes and such with the surgeon. Done all the research on the surgeries available and which one I wanted and tried the different Protein shakes and powders so I knew what I could drink. Plus started walk, what little I could, with my knees and back the way they were. With the weight off I'm up to over a mile now. But it took surgeries to fix things after my bypass and weight loss to get there. *smiles* Hope this was helpful.

[businessmom2011 4]

I have been completely different by my doctor's office for Medicare coverage, as this is my ONLY insurance.

I have been informed that I only need a 3 month diet plan with my nutritionist. I have just had my 1st appt. this week. My 2nd appt. is scheduled for June 9th.

I have had to get an Upper GI Series Xray because I have a lap band which failed and now I am getting the gastric bypass. So on surgery day he will remove the band and do the gastric bypass.

Also, you need a psych eval. They are a lot of money but I stumbled on a website called http://bariatricpsychevaluations.com/

They do not take Medicare BUT GOOD NEWS...they only charge $100!!!

All I can say is that after my next apt with my nutritionist in June, we are submitting to the insurance (Medicare) and the office said it only takes 8-9 days for approval and I am hoping to get surgery by end of July.

I also have to take a sleep test to make sure I do not have apnea (this was the doctor's decision), he wants to make sure things go smoothly, and I cannot blame him, as I do not want any problems.

So all I can do is keep you al posted about how things are going with approval. Hope this helps!!!

[StabMyFinger 19]

I have medicare & tri care for life. I hae an appointment tomorrow for a chest xray, gallbladder ultrasound, upper GI, EKG. I don't have to have a manogram because I'm not due one. Next week its the nutritionist.... Not sure how that will go, or how many visits. The week after its with the shrink. I sure hope its all worth it. I have a lap band and they will remove it and to the bypass.