Whats Kaiser and or medicares requirement?

[rene2005 0]

I don't have any diet documentation. DO you know what theres are? Do you always have to have a diet documented and for how long?

Thanks!

Rene

[giveyouthemoon 4]

I use Kaiser and they won't do lap band. They will only do a RNY. You have to have a BMI over 50 and two comorbidities (high bp, diabetes, chronic back pain, etc).

My BMI was a measly 47 and I ONLY have high bp....so I'm doing self pay because Kaiser is woefully behind the times.

[Snuffy 0]

I have both Kaiser and Medicare insurance. Kaiser does not cover the band but only RNY. I went outside of Kaiser and used my Medicare benefits to get the band. I was approved after the fact as Medicare does not pre-approve. I had to have a BMI over 40 and at least two co-morbidities which I did. I paid 20% of what Medicare considered reasonable and customary. The surgery cost me approx. $1500 which included a $799 program fee which was not reimburseable by insurance. Medicare has also covered my fills.

By the way, I am in Maryland. I don't know if you can go outside of Kaiser and use your Medicare benefits in other state. If you have any other questions, I'd be happy to answer.

Stephanie

[rene2005 0]

Hi I'm in California. I have medicare senior advantage Kaiser. I went to the NIH last yr and loved it for my chronic disease which I still have. Anyway I swear I read somewhere Kaiser does cover lap in san fran. I guess I was wrong. I could dis enroll and just use medicare.

When did you get yours?? 40 BMI and TWo medical conditions??? Thats a lot. Did you have to show proof of diets that failed? I do know I have read medicare does consider obesity a disease now of its own. Maybe they changed thier quidelines.

Your right that different Kaisers do different things.

Thanks all for the info. I think I'll go to San Fran too to get mine done.

Thanks,

Rene