Medicare anyone?

[zoomomma 1]

Hello all. I am wondering if anyone has used medicare to get the lapband?My husband is going to switch jobs before I can get the surgery done. Don't know if he will even have ins, much less if it will cover it. I am on disability and am eligible for medicare in a little over a year. I'm just wondering how difficult it is to get the lapband through medicare. What are the requirements? How much do they cover? stuff like that. Any info would be appreciated. I want to make sure and get all the stuff they want done so that I am ready to go when I get it. Have only lost a pound on this diet through the doctor. She's taking it slowly so I don't go into "starvation mode". Not losing much, though. Kinda depressing sometimes. I know I shouldn't compare myself to others but sometimes seeing people who succeed with just diets is really depressing when you can't do it yourself, you know. Anyway, just wanted to ask and see what kind of info I could get. Thanks for this great group by the way. Anytime I get depresses or discouraged I come here and get a pick me up. Knowing there are other people out there who struggled like me and still succeeded helps so much. Thanks a bunch.

[GayleTX 1]

There will be others who can give you much more information that I can, but I just wanted to say that yes, medicare will approve the surgery...however, there are very few doctors that will accept medicare insurance for weight loss surgery - at least in my area, it may be different in other areas.

You and I must be about the same age....I hope you are able to have surgery and that it improves your life as much as it has mine. Best wishes to you!

[SalOdyssey 441]

I am using Medicare, except that I live in FL and will have the Lapband done in NY. Apparently there are different rules for medicare and how the reimburse the doctor in different parts of the country. NY is apparently less restrictive with the before surgery requirement, whereas FL requires 8 months supervised diet before a surgeon will even see you. I have to call my surgeon either this week of next to hopefully get a date. I got only a few things left too do, Greenfield filter, Physc consult, gall bladder ultrasound and endoscopy.

Sal

[bklyn1984 0]

I would check the insurance forum here too. What I do know is very little but like the other person here said yes they do cover this surgery. They also require that you go to what they call "Centers of Excellence" in Bariatric Surgery. If you do not then they will not cover you at all.

Here is a link to locate a Center of Excellence in your area:

Surgical Review Corporation

I would call Medicare to find out exactly what they require. But here's what I found for you.

http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2=viewdecisionmemo.asp&id=160&

[terilynn112 1]

Here in NY it just has be a center of excellence (mine is), you have to have a bmi of 35+, and 1 co-morbidity (they have a shorter list than most insurance companies).

That's how I'm getting mine :biggrin:

teri