Medicare...

[#9grammy 274]

I received news from my case worker yesterday that Medicare needs no approval. Has anyone else has the sleeve with Medicare as your ins? They gave me a date of Oct 27th for surgery.

Just said they send all your paper work in after surgery. I've had to jump through hoops with all that I've done so here's hoping she's right. I don't want to go through the surgery and find I owe the dr and hospital.

To be safe I think I'll call medicare myself.

[finediva 979]

Yup. Good idea.

[ProudGrammy 8,322]

I think I'll call medicare

@@#9grammy

from one grammy to another

checking and getting something in writing is always the way to go

I am pretty sure - 99.9% that NOW medicare does cover the sleeve (past year or so)

but.............get it in writing from medicare

best of luck to you

here's my story.........

warning, warning - long post - i'll give you a minute to get a large glass of water!!!

welcome back

i will start by saying i WAS eventually approved by BC/BS

3 years ago i was trying to get insurance approval to pay for my sleeve

for various reasons i had to retire taking disability retirement and ss at the age of 53

medicare had to be my primary insurance as i was applying for insurance

my doctors office explained medicare doesn't cover the sleeve

i called them (medicare) and they verified that they only covered the lapband and gastric bypass (too many reason to list why i didn't go that route by default)

here's what was explained to me - and i did have to follow these "rules"

medicare said i first must have surgery (no insurance approval at the time)

in otherwods go into surgery blindfolded with no approval by insurance yet!!!!

Not until AFTER surgery could i send in my paper work to medicare

Medicare had 30 days to respond - - an automatic no would be the response

then docs office would could send paperwork from medicare to my secondary insurance - blue cross blue shield from my former employer (the state of NY) and i would be approved

i was concened/nervous - docs office told me that things "would be fine" famous last words!!!!

my doc's office said "oh yes, oh yes" now your 2nd insurance will approve you, and that will be it!!!

so............i proceeded with my sleeve in december 2011

surgery and PO and new life continue to be wonderful

but........hold onto your hats

mid february 2013 (DOS 12/15/11) i received a long statement/bill from the hospital/doctors/anesthia etc.

bill was for twenty two thousand dollars (and change)

What, what??? are you kidding me

called bc/bs and explained my story and they said something like- "sorry you owe us the money!!! :o"

spoke with the same case manager many many times (she was very helpful and sympathetic)

remember my DOS was 12/15/11

May of 2013 - case manager called to say i was officially approved

i screamed of joy and happiness (my mom heard me in CA - i live in NY!!!)

i then said "please send me the "official paperwork"

in a week i got copy of bill/statement marked with a big red stamp PAID in FULL

i was almost in tears, while DH was sighing in relief

alls well that ends well, I guess

bottom line in life in general - i learned the hard way

I always make sure all my i's are dotted and my t's crossed!!!

i end my story "with official" documentation stating

"I am one happy/relieved insured sleever patient "

so, thats my story and i'm sticking to it!!!

kathy

Edited September 13, 2014 by proudgrammy

[deb1327 15]

Did they cover