Just decided to have bariatric lap band surgery

[Sandra Lail 1]

I went to Medicare.gov and asked if they would pay for lap band surgery. I have tried everything to lose weight, and most of the time I gain. I went to a gym at a local hospital in Hickory, NC and really worked hard at it for 2-3 months. I gained instead of losing. People were telling me I was gaining weight because muscle weighs more than fat. Then, I tried Water exercise for 3 months and lost 9 pounds, but, after that - nothing. I do not eat much at all, but I will say that because I have a BMI of 42, my knees kill me to walk, I have COPD and emphesyma, congestive heart failure, sleep apnea and sleep with a CPAP machine at night, I have to take pills to regulate my heart beat, and have absolutely no energy. My endo doctor diagnosed me with nodules on both sides of my thyroid, but had me on the lowest dosage of Synthroid possible. Still don't know if it's cancer or not, but I was told I had the smallest thyroid he'd ever seen. I know that if I could lose this weight, I'd feel better, and possibly be able to get off some of these meds I'm on. Medicare said they would pay for the lap band when you go to the web site at medicare.gov. I can't find a place to see if NC Medicaid will pay for the rest. I have Medicare parts A & B, Medicare prescription coverage, and Medicaid. I only make a little over 9,000 a year. I can't afford to pay for the surgery and doctor. My daughter is doing this in Ms., and she was able to buy her power shakes over the counter. Can anyone tell me if Medicaid will cover the other part of the surgery and doctor bill? Or will I have to throw in the towel and forget about it?

[1Day1Life4Now 882]

Don't throw in the towel. You can do the research to find the answers to your questions. The band requires regular adjustments that can be costly so you might want to consider that when doing your research. Medicaid/Medicare will pay for the gastric sleeve too so check into that. The Protein Shakes you buy over the counter can be purchased at Walmart, Walgreens and Costco/SAM's. Any of the weight loss surgeries require healthy eating and healthy foods don't come cheap so you will need to commit to that. I am also in Ms and I had my sleeve done almost 5 weeks ago. I love it. Hope your daughter is doing well with her WLS program. Good luck to you.

[Sandra Lail 1]

My daughter is in the beginning stage of the lap band surgery. She's gone through the six months of seeing her primary doctor, getting weigh-ins, talking to the dietician, etc. I believe she actually has her surgery next Monday. When I looked it up online for Medicare it said that it did pay for the lap band surgery. I told the Lake Norman Weight Loss Surgery Hospital that I had Medicare and Medicaid they told me they accepted it. Now I've got someone else saying only Medicare will pay and I'll have to pay the rest out of pocket - and there is no way I can afford that. I guess I'll just have to keep right on digging and trying to get more information. Thank you so much for your input.

[MzEboni912 177]

I went to Medicare.gov and asked if they would pay for lap band surgery. I have tried everything to lose weight, and most of the time I gain. I went to a gym at a local hospital in Hickory, NC and really worked hard at it for 2-3 months. I gained instead of losing. People were telling me I was gaining weight because muscle weighs more than fat. Then, I tried Water exercise for 3 months and lost 9 pounds, but, after that - nothing. I do not eat much at all, but I will say that because I have a BMI of 42, my knees kill me to walk, I have COPD and emphesyma, congestive heart failure, sleep apnea and sleep with a CPAP machine at night, I have to take pills to regulate my heart beat, and have absolutely no energy. My endo doctor diagnosed me with nodules on both sides of my thyroid, but had me on the lowest dosage of Synthroid possible. Still don't know if it's cancer or not, but I was told I had the smallest thyroid he'd ever seen. I know that if I could lose this weight, I'd feel better, and possibly be able to get off some of these meds I'm on. Medicare said they would pay for the lap band when you go to the web site at medicare.gov. I can't find a place to see if NC Medicaid will pay for the rest. I have Medicare parts A & B, Medicare prescription coverage, and Medicaid. I only make a little over 9,000 a year. I can't afford to pay for the surgery and doctor. My daughter is doing this in Ms., and she was able to buy her power shakes over the counter. Can anyone tell me if Medicaid will cover the other part of the surgery and doctor bill? Or will I have to throw in the towel and forget about it?

I have Medicare and Medicaid and they paid for everything. I would suggest you try some Protein shakes. Greek yogurt also helps me for a snack. Please keep working on this your health is important. I have HBP, High Cholesterol, Arthritis, Insomnia. I went to the doctor last week and he took me of my acid reflux meds and took blood work to see if I can stop my cholesterol meds. I waa banded on January 27. When I went to my first doctor's appointment on September 27 I weighed 249 now I am down to 215. Please keep me posted on what happens.

Edited March 15, 2014 by MzEboni912

[JOANNE M HOLL 388]

The Bariatric Center may be able to help answer your payment coverage. They have a record of how it is handled in your state. Suggest you ask for their help. Also your Primary Care Provider should write you up as a candidate for the surgery, and your coinsurance or maybe medicade will pick up the balance & future visits.

Good Luck!

Jo

[Bandista 7,466]

I agree with Joanne -- the weight loss center or hospital should be able to help you with the billing questions. Keep at it -- choose Sandra first! You deserve health and happiness and you're going to get there. So many people here have similar stories. I am so glad you found this forum. Keep us posted!

[rosettag 122]

Hi Sandra, you say that you don't eat too much, but you don't lose weight.

The band helps people who are used to eating huge amounts of food, but if you have metabolic problems, how can a band change the situation?

Here in Italy surgeons suggest other kinds of surgery (bypass) to people who can't lose weight because of their metabolism.

Hugs!!

[Sandra Lail 1]

I decided to go ahead and start out with the Protein Shakes and Lean Cuisine and Weight Watcher meals in the evening, and see if I could get a good head start on this. I'm going to see my primary care physician Monday, and ask him for a referral. Since I do have a metabolism problem, I'm not sure whether or not this would help me or not. I know I need to find out if the nodules on my thyroid are benign or malignant and get that taken care of first. Hopefully that will be done sometime next month. The surgeon increased my Synthroid from 50 mcg. to 100 mcg. and that seems to be helping a little bit with my not having any energy at all. I've lost 6 1/2 pounds since I started the shakes and those diet meals at night. I don't know if I'll be able to do that everyday or not. I really don't want to lose the weight this fast, either. I just started this a few days ago. I know that losing too fast will just leave me with a lot of saggy skin. I think I'll give myself one or two days a week at eating what I want to, but sensibly. Not pigging out or eating a lot of fattening food, just eating normally. I appreciate all of your comments. Thanks so much. I need all the information and help I can get!

Sandra

[SandyM 1,956]

Most of the time we think we don't eat much and can't understand how we gain. A lot of the time it's due to bad choices. I suggest the app myfitnesspal or Loseit to track your intake closely to see what it is you are truly eating. The band may or may not be an option for you but the first thing you need to do is see what caused your obesity. Welcome to the site and you'll get lots of info here, but like any other place you have to cull through and make sure you get useful to you.