medicare approval

martucci · 04-10-2008, 10:41 PM

Thank you . I did get a great letter from my primary doctor to my insurance co. I was told they will cover the surgery if you meet the qualifications and believe me I do. Thanks
Karen

jasonlugoffman · 04-10-2008, 10:44 PM

Quote:

Originally Posted by martucci

Thank you so much, you are so sweet! I will call tomorrow. Hey, that was easy right, 1 800 Lap Band, ha!
Thanks again, Bless you too! Best of luck on your journey!
Karen

well thank you lol!!! let me know how everything goes im sure you will be very happy it might take a couple of weeks for your packett to come in the mail but be give it some time and it will come also you can call them back at any time and they should tell you who takes your insurence so let me know if you got any questions let me know ok but let me know what they said ok cause my doctor said thats the only one he knows that will do the surgery and if i find some one else let him know he will refer me and i called that number and they found me weight manage ment center and im real happy with there program so far

martucci · 04-11-2008, 09:08 AM

Hi, it's me again. I called the Lap Band number and they are sending me a list of surgeons in the area. They said to go to the surgeon that takes my insurance. I am confused as I had my primary doctor fax my info to the insurance co. and put somebody's name on that they don't know if they are in network. Now I don't know if I should go see a surgeon , don't want to get insurance mad at me either.
Well thanks a bunch, hope to get the list soon.
Karen

strikeuptheband · 04-11-2008, 09:34 AM

Quote:

Originally Posted by jasonlugoffman

hey a couple of years ago my dad went to the va here in fort jackson and they told him that he can get a va loan to do it well he didnt want a va loan and just waited it off he went this year and the doctor told him if he didnt get the surgery he would die and he asked them again and they did it for him at no cost but he had to go were you get a va loan but they directed him in the right path were it was covered i dont know what he did but i do know the people in the office were you get a va loan at helped him out with it so you may want to try there

Thanks, Jason. I might need to look into getting a loan. Hate to do that tho, and it gripes me that the VA wont do this life saving surgery but they will (maybe) give you a loan so you end up paying for it.

Gee, and usually I am such a happychick!

Can you get any more info from your dad? Did the VA eventually do the surgery and just charge him or did he get the loan and pay another doc to do it. I have a doc all lined up and have approval, but my work insurance wont cover this. Thats why I went to the VA to see if I could get it thru them. I knew as soon as I saw the skinny *itch of a doc that the answer was gonna be no. She said I could just diet and exercise (like I haven't been doing that and failing and hurting myself for the last 30 years???) I wonder if the VA rate is cheaper than an outside doc. The doc I saw would do it if you paid up front 12,500.

jasonlugoffman · 04-11-2008, 12:25 PM

Quote:

Originally Posted by strikeuptheband

Thanks, Jason. I might need to look into getting a loan. Hate to do that tho, and it gripes me that the VA wont do this life saving surgery but they will (maybe) give you a loan so you end up paying for it.

Gee, and usually I am such a happychick!

Can you get any more info from your dad? Did the VA eventually do the surgery and just charge him or did he get the loan and pay another doc to do it. I have a doc all lined up and have approval, but my work insurance wont cover this. Thats why I went to the VA to see if I could get it thru them. I knew as soon as I saw the skinny *itch of a doc that the answer was gonna be no. She said I could just diet and exercise (like I haven't been doing that and failing and hurting myself for the last 30 years???) I wonder if the VA rate is cheaper than an outside doc. The doc I saw would do it if you paid up front 12,500.

you know its sad that a person puts there lives on the line in war and serves his country and they cant even get better help you would think they would help better insted of putting people on the run around i hope you can find some help good luck god bless

jasonlugoffman · 04-11-2008, 12:30 PM

Quote:

Originally Posted by martucci

Hi, it's me again. I called the Lap Band number and they are sending me a list of surgeons in the area. They said to go to the surgeon that takes my insurance. I am confused as I had my primary doctor fax my info to the insurance co. and put somebody's name on that they don't know if they are in network. Now I don't know if I should go see a surgeon , don't want to get insurance mad at me either.
Well thanks a bunch, hope to get the list soon.
Karen

now when you get this list you can call around and see if they will take all the insurence that you got and if another doctor takes it you can have your primary doctor refer you again just tell him you are not happy with this doctor and you feel you found a better one now this packett took about two week to get to me but it may be sooner for you so this is just another option for you plain b lol!! i hope you find some one that helps you so keep me posted good luck and god bless

strikeuptheband · 04-11-2008, 12:33 PM

Quote:

Originally Posted by jasonlugoffman

you know its sad that a person puts there lives on the line in war and serves his country and they cant even get better help you would think they would help better insted of putting people on the run around i hope you can find some help good luck god bless

Jason, I googled VA loans and all I can find is info on home loans. Do you have a link to where I can check out if VA will give you loans for medical needs? Thanks,

jasonlugoffman · 04-11-2008, 12:52 PM

Quote:

Originally Posted by strikeuptheband

Jason, I googled VA loans and all I can find is info on home loans. Do you have a link to where I can check out if VA will give you loans for medical needs? Thanks,

no i dont im sorry buy try calling them and see if they can steer you in the right path mean while ill call my dad and see what it was he did and how he did it

JudyAnticola · 04-11-2008, 07:24 PM

Quote:

Originally Posted by jasonlugoffman

hey a couple of years ago my dad went to the va here in fort jackson and they told him that he can get a va loan to do it well he didnt want a va loan and just waited it off he went this year and the doctor told him if he didnt get the surgery he would die and he asked them again and they did it for him at no cost but he had to go were you get a va loan but they directed him in the right path were it was covered i dont know what he did but i do know the people in the office were you get a va loan at helped him out with it so you may want to try there

Thanks for all the replies. You are correct, UHC does cover it, my company does not have that plan. CHAMPVA does cover it and I am going to try that. In the meantime I am trying to get info for self pay just in case. I have not found a way to upgrade UHC, but I would ask your employer. To "strike up the band" since you are the veteran I agree you do deserve it. Find a good Veterans Service Office to help you and fight like crazy.

Linda Davis · 04-14-2008, 03:25 PM

I have Tricare now and will be on Medicare on May 1. I have finished all the pre op stuff, waiting for the last 2 reports to be faxed to surgeon's office. Dr Stewart said that Medicare is much easier to get approval that Tricare so am shotting for first of May for surgery. My bmi is 32, however I have sleep apnea, high bp high cholesterol, osteoporosis, degenerative arthritis, gerds,fibromilga. On 9 Rx's, he says it should go thru with no problem sure hope so. Thanks Linda

martucci · 04-14-2008, 04:47 PM

Gee Linda, I have all the things you do except fibromalgia.I have copd also. Best of luck. That's great you can just get set an appt. I guess you did the 6 months? Did you do that with your primary or surgeon?
Karen

Linda Davis · 04-15-2008, 11:23 AM

Good Morning Karen, Thanks for the support! I have a record of several diets that my doctor included in her letter of Necessity. It appears that I do not need to have a 6 month period, no one has mentioned it and they made me a appointment for May 1 however said if we got all the requred documents in they would cancel it and make sugery date. Please lord that will be it!! Anyone else have any experience with this?
My daughter-in-law's mother had the surgery in Jan with medicare and it went thourgh with no problem in about a month. She has lost 25 lbs so far!

martucci · 04-15-2008, 12:15 PM

That's great Linda! You are so fortunate to have had the diets in the record. I don't and of course I haven't dieted the last six months, gave up. Just gain it back. I wish so bad they would let me get it, I have lots of medical issues and my knees are tearing, the cartiledge.
Did your daughter in law's mother have the 6 month diet on record too?
Well thanks for answering and best of luck to you!
Karen

Linda Davis · 04-15-2008, 04:42 PM

Hi karen I don't know if she did or not but i know she did not have a 6 month delay for her surgery. I heard something about differant states having differant guidelines but may have been for something else sorry I am not much help. :(

martucci · 04-15-2008, 04:53 PM

Linda , that's okay. I am praying to skip the 6 month thing, LOL!
I really wish they would but I will see when I hear from them I guess.
Well, will let everyone know when I do hear from them.
Take care!
Karen