medicare approval

cheerios124 · 05-15-2006, 12:52 PM

I read on the medicare website that they now cover the LAP-BAND® procedure- Am I right? I wanted to know if there is anyone out there that has it that can confirm it so I don't have to call and go through the hassle. Also, I am 27 BMI of 45, went to a nutritionist, went on weight loss drugs, so have a history of trying, but have only been like this for 3 years. Do you think I am going to pass through? Thanks, Jessica

Mvpo8961 · 05-17-2006, 11:21 PM

Just bumped up a thread in the general forum about facilities of excellence that medicare has approved for LAP-BAND® surgeries.

M

coyotegirl · 05-18-2006, 12:21 AM

Medicare paid for mine in Nov of 04. I had no problems at all with them.
Good luck

bluebird · 04-02-2008, 06:45 PM

hello, first time poster, I have Medicare A and B as well as Medicaid, seems each time i try to get weight loss surgery something changes in requirements. and the PA i see, admits she really is not up on what help Medicare is in this, only Medicaid. does Medicare A/B help , do i have to use the Medicaid? my bmi is 56 and i have DJD and sleep disorder, high bp etc, not diabetes tho. i am told have to be about to have knee replacement, that sleep disorder is not longer part of issues that are considered with Medicaid, so again,, i look to see if Medicare, A/B can be used solely as the insurance. or does having both mean Medicaid is the only one to be used. thank you so much for reading this look forward to your reply,

JudyAnticola · 04-04-2008, 08:34 PM

It never occurred to me that my insurance might reject coverage. I have United healthcare but not sure what level of coverage. Are there some companies that do not pay for this?

Any idea what it costs to pay for without insurance?

charlimc · 04-05-2008, 11:30 PM

As long as you get a refferal from you doctor to get the LAP-BAND® surgery Medicare does cover

jasonlugoffman · 04-06-2008, 01:06 AM

Quote:

Originally Posted by bluebird

hello, first time poster, I have Medicare A and B as well as Medicaid, seems each time i try to get weight loss surgery something changes in requirements. and the PA i see, admits she really is not up on what help Medicare is in this, only Medicaid. does Medicare A/B help , do i have to use the Medicaid? my bmi is 56 and i have DJD and sleep disorder, high bp etc, not diabetes tho. i am told have to be about to have knee replacement, that sleep disorder is not longer part of issues that are considered with Medicaid, so again,, i look to see if Medicare, A/B can be used solely as the insurance. or does having both mean Medicaid is the only one to be used. thank you so much for reading this look forward to your reply,

im from south carolina and i have both medicade and medicare a/b my doctors office told me that medicade and medicare will pay for it all what medicare dont pay for medicade will pick up i hope this helps ya some

foolsrushin772 · 04-06-2008, 01:49 AM

Just a short note to let u know medicare does pay forthis because I was just banded march 21st. Had no problems whats so ever. You do have to go to a center of exllence however. And some states have 6 month supervised diet plan. That was my state, I live in South dakato, so i went out of state. I went to detroit mi. Had surgery date in 2 weeks. Didn't even need alot of tests. Had surgery on a fri. and was home mon. Everything went just like clock work. I had no gas, no pain and just fine in one day. I was one of the lucky ones. I'm still on full liquids and will be on them another 3 weeks. Some people go right into solids, but u need that time to heal. Sorry this got long..............but don't worry about medicare paying...............Sue

JudyAnticola · 04-07-2008, 08:55 PM

I was wondering how to get medicare coverage. I am 57 but will not be eligible for coverage for a few years. I think you said you are 27, how did you get on medicare, if you dont mind my asking?

Thanks, hope you are well.

foolsrushin772 · 04-07-2008, 09:16 PM

Judy.......no I'm 59, but I'm on disabilty social security. Thats why I have medicare!!!!!.....theres noway u could get it at 27 darlin.........Sue

foolsrushin772 · 04-07-2008, 09:18 PM

oops I mean u r 57...........sorry!!!!!!

jasonlugoffman · 04-07-2008, 10:05 PM

Quote:

Originally Posted by JudyAnticola

I was wondering how to get medicare coverage. I am 57 but will not be eligible for coverage for a few years. I think you said you are 27, how did you get on medicare, if you dont mind my asking?

Thanks, hope you are well.

no im 30 lol i wish i a 27 again but any way i dont mind i get medicare due to a mental disability bipolar and manic depression and i get social sec. dis.

04-08-2008, 09:58 PM

As of Jan 1st 2008 they cover weightloss surgery...They have a lot of guidelines though...
Bmi over 35?
type 2 diabetes
Sleep Apnea

and many more...

martucci · 04-09-2008, 11:58 AM

Hi,I have a Medicare Advantage plan and they use Medicare guidelines they said. My doctor sent a letter with all of my medical problems and bmi, etc. It has been a month and it is still being reviewed. I hope they approve me. But did you have to do the 6 months of diet? Does losing weight on diet hurt in any way? Thanks
Karen

JudyAnticola · 04-09-2008, 06:06 PM

At this point my company does not cover the LAP-BAND®. I have checked with every possible person. I will have to self pay, but it will be worth it right?