Medicare Coverage of Bariatric Surgery Important

chichigirl · November 26, 2005

For any of those of you who are covered with Medicare or Medicaid as you insurance carriers, you need to know about a decision they are in the process of making regarding their coverage of bariatric surgeries.

At the moment, they are seriously considering approving both the RNY and the lap band surgeries for people with at least one comorbity under the age of 65.

However the site I will give you the information for is their site for people to make comments on how they feel about this. The hearing was done on the 23'd of November and there is a short window in which they are accepting comments. You can also access the comments by others, so prepare to put on your boxing gloves, casue believe you me there are an awful lot of people out there that believe the only reason we have weight issues is because we are too lazy to diet and exercise and they oppose the tax payers money going towards these surgeries. So, if you would like to voice your opinion, please go to the following site: www.cms.hhs.gov, choose Consumers, then Media Headlines, then Medicare proposes new coverage policy for bariatric surgery procedures. This site will take you to what they are proposing so you can read and understand what they have in mind.

The other site, www.cms.hhs.gov/coverage, Public Comments, Submit a comment, go to second box at bottom of page and choose Bariatric Surgery for the treatment of the morbidly obese. This will take you to the site where you can read other peoples comments and make one of you own.

I can't tell you how important I believe in fighting the ignorance of those making uneducated comments and judgements about people who suffer from obesity. I will not stand idly by and allow these kinds of people dictate what is best for me, especially when they don't have my welfare as their concern. One comment that was made even made the statement that the statistics only show an average of a three year extension of life and the money used for the surgeries should go towards better causes. Does this have a ring of the things Hitler used to talk about or is it just me. He though if you were Jewish, gay, or didn't have blonde hair and blue eyes, you didn't deserve to live.

Okay, I have alreay made my comment on this site and I have spread the word here. Now it's up to any of you who are interested in fighting the good fight to add you words. Whether or not you agree with me, that is not what's important, the fact that we get involved, and aren't we already by having had the surgery or are planning on it already involved?

Cindy

chichigirl · November 26, 2005

By the way, this is the official site for Medicare, it's not a fake organization, it's the real deal.

Cindy

tomorrowsdream · November 26, 2005

On my way now to read it and send in comments Cindy. I feel as strongly as you do about Medicare and coverage. I knew they were going to be making some sore of decision this month, and supposedly on Jan 1 were going to be covering it. I will have to read and see what it says. Medicare-dammed if it doesn't make you mad that they consider alcoholic a disease and pay disability to the drunks and will deny us benefits. I love a good fight too. Back again....soon.

tomorrowsdream · November 26, 2005

Thanks for the info. I better hurry up this surgery. I'm very thankful I'm not 65, but I think it is unfair for our senior citizens not to be offered lap banding. That is segragation. They are much more liable to die from the effects of being overweight as their younger counterparts. That just isn't a fair decision. I've put my 2 cents in and hope others do the same.

Thanks for the site Cindy.

ladysplenda · November 26, 2005

I have a friend that is in a nursing home at Age 42. She has many health problems because of her weight and is in a wheel chair. She is unable to have the surgery because she could not get them to pay for it. They would rather pay for a nursing home till she dies ????

tomorrowsdream · November 26, 2005

That's rediculous at that age and her physical state they wouldn't authorize the surgery. I see no reason for half of what they do or don't do.

chichigirl · November 26, 2005

I think that's why it's so important when we have an opportunity to voice our opinions to those who are making the decisions, we should take advantage of that. It's really easy to do and you can make the comment as short or long as you want.

DrHekier · November 27, 2005

One comment that was made even made the statement that the statistics only show an average of a three year extension of life and the money used for the surgeries should go towards better causes.

We would never deny chemotherapy from someone with metastatic cancer which might have a 6 month likelihood of survival.

It is all a matter of public perception as to what we 'expect' from our healthcare system. I personally think there are much more frivilous uses of healthcare dollars than bariatric surgery.

there are an awful lot of people out there that believe the only reason we have weight issues is because we are too lazy to diet and exercise and they oppose the tax payers money going towards these surgeries

1) Approximately 127 million adults in the U.S. are overweight, 60 million obese. Does anyone really think this is simply a disease of laziness? If so, are 127 million Americans lazy? That is rather disparaging to suggest that. Also, the IRS accepted obesity to be a "medical disease in its own right" in 2002.

2) See above

But I suppose I'm preaching to the choir here. It's other people that need to be made aware.

chichigirl · November 27, 2005

Thank you Dr. Hekier, for your support and your wisdom. It is nice to know that there are physicians who understand this as a disease and not something brought on by laziness or just being greedy with food.

Cindy

coyotegirl · November 27, 2005

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I don't understand why Medicare wont cover Lap-Band now when they DID COVER IT in November 2004. At least they did for me. I had no trouble at all and they paid the 80% they usually do.

I was 294 at time of surgery and had High bp. Other than my spinal disorder I had no other health problems.

Why then and not now?

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chichigirl · November 28, 2005

Coyote Girl,

I am sorry for the misunderstanding, it's not that they are considering not covering the band for everyone, just for those over 65 years of age. It is not a done deal, but I thought people might be interested in voiceing their opinions to the people who are making decisions for us. It doesn't mean you have to agree or disagree, you can just let them know how you feel. Considering there have been others on this board who are that age or close to it, I though perhaps it might be of interest. I personally just wanted to let them know how wonderful the band had been for me, even though I have multiple co-morbidities and very poor health when I was banded, but faired just fine.

Sorry again for the confusion.

Cindy

Nykee · November 28, 2005

My health care is costing medicade more each year than the one time cost of the lapband and everyone of my healthcare issues costing them each year is Obesity related..

FOOLS!