Medicare Approval

[LainieG 132]

Has anyone used Medicare for covering surgery ? Is it submitted to medicare after all tests are done ?

Is there required weight loss and how much or for how long ?

[Arlene G 31]

I am sixty five and decided to have the gastric sleeve after much thought, this past spring. After thoroughly researching gastric bypass surgeons in my area, I attended one of their seminars in July.

I did not have a weight problem till I started taking Lexapro about fifteen years ago.

The first thing the office did after that seminar was check to see if insurance covered the procedure of all those who attended the seminar.

Then I was told that I might be required to be on a 3 month medically supervised diet. I had my medical records for the past 3 years faxed over to the surgeon's office. What Medicare was interested in was how much I weighed for the past 3 years and what other health problems I had due to obesity. I spent a few days getting this paperwork in, went to my PCP for a letter of medical necessity to Medicare. I was then told that I did not need to be on the 3 month medically supervised diet. This surgeon's office requires a complete blood panel, chest x-rays, EKG, and upper GI tests. My surgery is scheduled for Sept. 9th. I was told it would be way more difficult than this.

[LainieG 132]

I did not attend a seminar at the time I saw the doctor. I am going tomorrow evening. I am on Medicaid right now but go to Medicare in October. I saw the doctor several months ago and have done some of the tests but what is holding me up is some tooth repair which I had to save up 2600.00 for. That and all tests will be completed in October. I have not been told anything from his office about what medicare needs. Guess maybe I may find out tomorrow night or I will call them. My weight has been the same for several years within 10 - 15 pounds either way. I lost 40 3 years ago but that was due to leukemia. I have since put that back on. Yours seemed to be a snap, hope mine will be too !!

Good luck

I'm adding you as a friend if you don't mind, let me know how it goes for you

[Arlene G 31]

Will do. Seems like the days keep flying by and before I know it the day will be here. Have to do a pre surgery diet with the Protein shakes and one meal with four ounces of chicken or turkey, four ounces of green vegetables, and a list of liquids i can drink. No sugar is allowed in drinks. Everyone needs to lose a certain amount of weight before the surgery, usually about five pounds because of what is called fatty liver.

[lindalue 70]

I did not attend a seminar at the time I saw the doctor. I am going tomorrow evening. I am on Medicaid right now but go to Medicare in October. I saw the doctor several months ago and have done some of the tests but what is holding me up is some tooth repair which I had to save up 2600.00 for. That and all tests will be completed in October. I have not been told anything from his office about what medicare needs. Guess maybe I may find out tomorrow night or I will call them. My weight has been the same for several years within 10 - 15 pounds either way. I lost 40 3 years ago but that was due to leukemia. I have since put that back on. Yours seemed to be a snap, hope mine will be too !!

Good luck

I'm adding you as a friend if you don't mind, let me know how it goes for you

Hi I am using medicare too. I am 67 hoping to have surgery in October

[#9grammy 274]

Hi, I have Medicare also and in my state they require 6 month supervised weight loss. Plus all the other, psyc eval, cardiologist and so on. I had my 4th wgt loss apt so 2 more to go, will b glad when Nov runs around here.

Good luck to all of you.

[simply_Me 61]

I have Medicare also and I'm on a 3 month supervised diet I won't be having surgery until nov. Good luck to you all!

[LainieG 132]

I am going to my family doctor on Tuesday and have him start me on an "official" three month diet. My plan is to replace one, maybe two meals with a Protein shake and an evening meal low in calories. That should get me close to three months, hitting November and hopefully near surgery time.No point in putting off all these changes, i.e. the weaning process !

Lene716, is yours scheduled for October ? Grammy, hope I am in Nov with you. Lindalue, let me know how yours goes.

Keep in touch all !!

Lainie G

"Making it happen"

I am 59 and on retired disability with a horrid bad back and am a cancer survivor

[#9grammy 274]

I am going to my family doctor on Tuesday and have him start me on an "official" three month diet. My plan is to replace one, maybe two meals with a Protein shake and an evening meal low in calories. That should get me close to three months, hitting November and hopefully near surgery time.No point in putting off all these changes, i.e. the weaning process !

Lene716, is yours scheduled for October ? Grammy, hope I am in Nov with you. Lindalue, let me know how yours goes.

Keep in touch all !!

Lainie G

"Making it happen"

I am 59 and on retired disability with a horrid bad back and am a cancer survivor

Hi LainieG, I too am retired/disability, and 57 years old. I should b sleeved in November. Going to call Medicare and see if they have a 3 month wait for Nutrician. My dr said 6 months and I've done 4 so far.

Welcome to this forum where help is just a click away lol.

Linda

[LainieG 132]

Hi Linda,

I can't believe that the requirements for a diet plan are different state by state. Medicare is federal and I thought all states were the same for everything, guess I just found out differently. I am going tomorrow night to the seminar so I will find out what Missouri has.

Hoping that I get everything done so I can have the sleeve in November.

Lainie