Medicare will approve Lap-Band Surgery! Approved facilities List

[susi1662 3]

Has medicare changed recently? I know that a few weeks ago, I was looking for approved physicians and facilities for AZ, and I found several listings, but now I can only find one facility in the entire country, which is in MD.

I called CMS to get information, and they told me the same thing. Was bariatric surgery taken off of the approved benefits?

Right now I am using my private insurance to pay for my surgery, but I was hoping the medicare would be there to help with some of the costs. I was even thinking of changing to a different doctor that takes medicare.

Now I am freaking out, because I will have to pay a HUGE copayment for the hospital.

Does anyone have any info on medicare benifit changes for bariatric surgery?

[LynnP 0]

I am a newbie to this forum. I live in Houston, TX. I have HealthSpring - Healthy Advantage Preferred HMO insurance. (Medicare HMO).

I have been trying to find out if they will cover lapband surgery. I am 55 yrs old, have been disabled since 1996. I have been overweight for at least 25 years now. I am 5'4" and weigh 315...my highest weight ever! . My BMI is 53.2

I have diabetes, high blood pressure & cholestrol, chronic pain, FM and back problems.

Does anyone know if my insurance covers the lapband? or what it would cost me to have it done?

or any info on it?

Thanks for your help!

LynnP

[bromo 17]

I live in Alabama and am on Medicare. I will be having my surgery in 2 days. There was no 6 months prediet needed. I fit the criteria with a bmi of 45 and high blood pressure. Because of my age (57) my doctor did make me take a nuclear stress test before he would do the surgery. Passed with flying colors. My out of pocket to the doctor was $220 for his services and $300 for the program fee which gives me unlimited access from now on to the nutrionist, fitness and mental health pros for a year. I am having a lap band with plication so will be staying overnight in the hospital. My out of pocket with the hospital was around $1100. So all in all my costs after insurance have been around 1700 dollars. I will save that in a year just not buying diet pepsi. (kidding). I did have to find a center of excellence as that is all medicare will accept but they are all over the place. Here is a link to a site to help you find a Center of Excellence in your area

http://www.surgicalreview.org/locate/

I do not know yet if they will pay for fills, but I will just use my potato chip and Little Debbie savings to pay for them if not.

[Ditzie 0]

I live in Alabama and am on Medicare. I will be having my surgery in 2 days. There was no 6 months prediet needed. I fit the criteria with a bmi of 45 and high blood pressure. Because of my age (57) my doctor did make me take a nuclear stress test before he would do the surgery. Passed with flying colors. My out of pocket to the doctor was $220 for his services and $300 for the program fee which gives me unlimited access from now on to the nutrionist, fitness and mental health pros for a year. I am having a lap band with plication so will be staying overnight in the hospital. My out of pocket with the hospital was around $1100. So all in all my costs after insurance have been around 1700 dollars. I will save that in a year just not buying diet pepsi. (kidding). I did have to find a center of excellence as that is all medicare will accept but they are all over the place. Here is a link to a site to help you find a Center of Excellence in your area

http://www.surgicalreview.org/locate/

I do not know yet if they will pay for fills, but I will just use my potato chip and Little Debbie savings to pay for them if not.

Hi, I'm on Medicare also. Do you have just original Medicare Part A and B only or do you have a Medigap Policy or Advantage Plan with your Medicare? I am In Springfield, MO and I am trying to find out what I need Insurance wise. I need to find out what my out of pocket will be. Can you PLEASE help me?

[bromo 17]

I have only A and B and no gap policy, so that is why my deductible was 1100 for the hospital and the 220 for the doctor. My surgeon's office let me know at the initial seminar what the out of pocket costs were for Medicare patients so I would imagine your office should be able to tell to what is the norm for his office and the hospital if that is the route you are taking.

[Msbenz 0]

Anyone found anything in Mississippi?

[sandsouza 1]

Thanks for sharing. Could you able to provide me Surgeon's name? Do they provide Medicare fills?

[#MagicWithinme 173]

I'm in California and I met a lady Saturday ,aged 70, who had lapband done, because her doctor told her that medicare wouldn't pay for gastric bypass but would approve the lapband.