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Waiting for Medicare to Approve



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Why woud Medicare cover the Gastric Bypass surgery but not the less evasive one like The Gastric Sleeve.???????? can someone help me understand this? I have been waiting to get the sleeve since December 2010.........

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They've been saying for over 2 years now that they'd pick it up "soon". . . I know it's unbelievably frustrating. Our insurance follow suit behind Medicare since it's government ran insurance as well.

The earliest I think we'd hear anything is going to be October because that's the fiscal year. At least that's how it works with Tricare.

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They've been saying for over 2 years now that they'd pick it up "soon". . . I know it's unbelievably frustrating. Our insurance follow suit behind Medicare since it's government ran insurance as well.

The earliest I think we'd hear anything is going to be October because that's the fiscal year. At least that's how it works with Tricare.

Thanks I currently have the lap band, i had the LB in 2007 my heaviest was 280lbs , i lost 85lbs between 2007-2010, now at 225lbs i am very interested in the gastric sleeve.

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They've been saying for over 2 years now that they'd pick it up "soon". . . I know it's unbelievably frustrating. Our insurance follow suit behind Medicare since it's government ran insurance as well.

The earliest I think we'd hear anything is going to be October because that's the fiscal year. At least that's how it works with Tricare.

That’s discouraging news, very frustrating, I’ve been waiting too. I’ve been emailing

Northeast Bariatric center Hazelton Pa they recently started doing the sleve. They implied that Medicare makes changes in February which is now.

I’ll still inquire later this month. I’ll post what I hear and I hope it's good news, but I know Tiffykins your sure doing your homework thanks for that.

Thanks . G

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Why woud Medicare cover the Gastric Bypass surgery but not the less evasive one like The Gastric Sleeve.???????? can someone help me understand this? I have been waiting to get the sleeve since December 2010.........

medicare c covers it CPT code is for VSG 43775 medicare C health partner (group health inc) and it should covered by medicare b by october 2011. medicare covers it now if you have serious liver problems your doctor must call the provider line and talk to the contractor with your situation, only the contractor can approve your claim and process it, if you lose you can appeal to the ALJ that is administration law judge. But you must have a serious liver problem by october it be for everyone stating next year as it cheaper for them than pass sad.

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 0 replies
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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