MikefromCO

WOW!!! Thank You Lene716,
This sounds even more encouraging. I appreciate the update.
Mike

Medicare has changed a LOT in the past couple of years. A person I know had the Lap Band in 2008 and had to jump through a lot of hoops. A documented 3 month pre-op diet, a lot of trying to get the surgery approved. So, with that mindset, I stated that this might happen before the end of the year. However, Medicare has changed a lot. I did not need a supervised 3 month diet. I had records of my weight for the past 3 years and, I have no idea why, but the bariatric surgeon's office stated this information they received precluded me from having to go on the 3 month supervised diet. I thought getting the surgery approved through Medicare would be a nightmare, but it wasn't. It seems, as I stated before, Medicare deems it more beneficial to pay for weight loss surgery than the complications from obesity. Like quadruple heart bypass surgery, or in nursing home stroke care. I am 66, went to the orientation for the surgeon I chose in July. I did, myself jump through hoops getting all the needed paperwork to the surgeon's office. One has to do a lot of this pre-op paperwork on their own. So for 2 weeks I sat on the phone asking that my medical records be faxed to the bariatric surgeon's office, I did go to my doctor to get a letter of medical necessity. I did have a psych eval done which lasted all of ten minutes, and this coming week I need to get an upper endoscopy done. Actually, the one hospital in my area..the Clearwater/St. Pete area has one hospital that has is a Center of Excellence. And they are booked by so many bariatric surgeons because of this reason. Medicare also doesn't require this either. Therefore I am going to another hospital closer by. The pre surgery diet starts around August 26th, and the surgery is scheduled for Sept. 9.

What in the world do you mean by:
"Gastric sleeve followed by banding"?
I've never, ever heard of that.

That is the order of which surgery he would prefer having as I read it.

Do you have a surgeon in CO? I'm not sure what you're asking? Are you asking if Medicare will cover you with your weight and co-morbidities? The answer is yes I do think you'll be covered if this is your question

I weighed in at a BMI of 39.9 on my first surgeon visit. So badda boom.
However, all the other CoE hoops I had to jump through (all successfully) were just backed up horribly there -- lots and lots of patient applicants. It's taken months and months and months.
So getting through by November depends on your surgeon's patient pipeline.
Good luck.

I am 66, was approved by Medicare for Gastric Sleeve. Yes, Medicare does pay for the sleeve. The only co-pay you may have is a small hospital co-pay, which your other insurance may cover. I am 5'3 and weigh 255. Wasn't overweight till Lexapro. But that is a story for another day. At this point in our lives, I guess Medicare figures it is less expensive for WLS than a quadruple bypass. My prior MD was small minded too. Told me I had to lose weight on my own. I am very hypothyroid and have tried. I also have BP problems. Couldn't leave this doctor's practice fast enough. Have an excellent primary care MD who has OKd the sleeve. At this point in our lives, are they really going to say no? When you mention gastric bypass, there is a more invasive procedure called the Roux-en-Y, the sleeve is less invasive. Best of luck in finding the best bariatric surgeon in your area. Again, as long as you are using Medicaire and not Humana or any type of H.M.O, you should be fine.