I'm furious!! First I had to wait over 3 months before medicare would pay for a fill.

So FINALLY, I have my first fill scheduled for July 13th.

I get a call from the doctor's office saying Medicare has just put through a stipulation that in order for them to pay for it, I must get my fill at a center or hospital of "Certified Excellence". My doctor does not belong to a place "certified" with them, and in fact they told me, there are very few in the country.

SO NOW I CAN'T GET A FILL!!!

I'm sitting here with a band in me that they paid for, and that I'm also paying for and it's doing nothing, NOTHING for my health.

Out of pocket would cost me over $650, and if I needed an unfill, that would cost me extra too.

Medicare will also not pay for surgery now unless it';s at a place "Certified Excellence", so if you have Medicare and your getting this done, you better look into it.

Leenerbups,

How far are you from Mexico? Dr Kuri does the fills for $95. with flouro.He

will fill you even though you were not one of his patients.

Mexico is out of reachfor me, I'm on the east coast and on a very limited income.

Foo. Foo. foo foo

My fills are $650 also since they're done at the hospital. Where do you get a list of the certified doctors and hospitals? I'm due a fill on July 21 and I'm on Medicare. I haven't heard a word about this yet.

Pat

Happy2,

Here's the link to the Medicare decision that's affectiing your ability to get fills: http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=160

Here's a link to the Medicare-approved Bariatric facilities:

http://www.cms.hhs.gov/MedicareApprovedFacilitie/BSF/list.asp#TopOfPage

My fills are $650 also since they're done at the hospital. Where do you get a list of the certified doctors and hospitals? I'm due a fill on July 21 and I'm on Medicare. I haven't heard a word about this yet.

Pat

Randi,

Eeekkk,

Randi,

Eeekkk, my hospital DeKalb Medical Center isn't on the list. Maybe they'll get approved by the time for my fill. This is unbelieveable. Thanks for the information.

Pat:omg:

Crikeey, this so stinks. I'm sitting here with a band instide that they paid for, going on 5 months with it doing nothing.

Thanks Medicare.

Okay here is an update and it's upsetting.

I called my doctor's office and asked what I was supposed to do now? hey said call Medicare and complain.

I said, I did complain but what do I do, I need fill and care, so will the doctor's work with me? I told them I am unemployed and had charity care with the hospital they work out of, so if the doctors would work with me on the fill .... I did not get help on that and they told me it would be $450 for the doctors to do my fill and did I still want to have my fill and have to pay for it.

I asked if they could refer me out to another doctor and they told me their is no places Medicare approved, and I listed the names off the link of hospitals that Randii posted. SO I didn't get a referral either.

So I'm very dissapointed in both medicare and that my doctor's office wouldn't lend me a hand with this. 5 Months post banded and no fill, nothing but a band sitting inside me.

I don't know what to do.

Maybe I should put up a "Pay for My Fill" Charity website or Ebay auction. jeez....

:-/

I just got off the phone with medicare again, and you won't believe what they told me...to travel to one of the "Approved Centers of Excellence".

Oh right, just what people on Medicare can afford to do.

I called the hospital my doctor works out of and they have no idea when they will get this freaking insane Medicare Stamp of Poop that leaves so many Lap Banders across the country out in the cold. NO CARE!!

Medicare Banders you better think twice now.

I'm also very ticked off at the lack of help and caring all the way around for someone in my postion.

**RANT OVER**

Leenerbups, Where did you have the band done? My hospital isn't listed but I had surgery Feb. 28 and they've paid for that surgery plus two fills. Maybe my hospital has been approved for more than 2 years, but it isn't on that list. What state are you in? How far are you from a Medicare approved hospital?

Pat

Hi Pat and thanks.

I had it done at Morristown Memorial in NJ. Morristown is not one of them. And my surgeons office doesn't include fills with their surgery price. I have Medicare and Medicare won't pay for any aftercare unless you have it done at a hospital they approve of, and there is only 3 in my state, one way down in South Jersey, one way up north of me and only one other doctor about 40 min away.

Now here is the kicker, the one 40 minutes away was the first surgeon I consulted with, and I decided to go with someone else.

He will remember me and it would be awkward to say the least. "Hi, remember me? I didn't think you good enough to do my surgery, but can you give me fills?"

I'm just freaking amazed that Medicare would leave people like me out in the cold without after care.

I traveled to Tennessee for my surgery because they won't even do surgery unless it is a center of excellence. I am lucky I have family here and they encouraged me to come here. I didn't want the surgery in the state I was from anyway. The dr's. there had only done about 50 lap bands between them. I was happy Medicare was recommending a center of excellence to be honest. A center of excellence means the dr. has done many, many lapbands. It basically has nothing to do with the hospital itself, but with the dr. My dr. here in Nashville has done over 1000 lapbands and therefore qualifies as a center of excellence. All my fills for 6 mo. are included.

Leener, can you run a google check and find a center of excellence not too far from you to get your fills at.

I've been working on my banding for about a yr. when Medicare threw this clunker into the works, but I have to admit at 64 I'm rather glad they did. I planned on coming to Tennessee anyway but to a dr. closer to Knoxville (Marysville) and he hasen't yet been accepted as a center of excellence and probably won't be, because he hasen't done over 1000 bands.I have found numerous things that were wrong with me that needed corrected before surgery that I believe I wouldn't have found anywhere else.

I traveled a long way to get this surgery and am staying for the fills, which are included for a 6 mo. period. I wish you luck in finding a center of excellence near by.

God Bless,

Dody

Hi Dody,

I'm glad it worked out for you.

Only three hospitals in my state qualify for this. None near me.

But to tell you the truth, this one doctor I was talking about who is in the CENTER OF EXCELLENCE had only done 100 bands, which is why I did not go with him in the first place. SO I really have to wonder at this "seal of approval"

In any case, i'm so upset. I went and had SURGERY, an implant put inside me, went through a rough recovery and now nothing. I have no aftercare paid for by Medicare.

And I'm not working, so I can't pay out of pocket.

This is not only frusterating me to the point of tears, but has me so worried now too.

The Centers of Excellence thing can be a real rip off. And far from excellent in some cases.

For comparison purposes though, I thought you might enjoy the following billling I received for a fill for in 2004:

They billed a total of $1573.07

I paid $251.30 (but they later refunded me $42.96)

Insurance paid $637.54

So, some of the prices in this thread sound like a real bargain to me.

Leenerbups...

I am so sorry that you aren't getting anywhere with Medicare! I find it appalling that your doc will leave you high and dry now that you are banded and can't get a fill. That's pretty crappy if you ask me! The band won't work without aftercare and it seems your doc is forgetting that.

Have you called "the other doc" to see about a fill? What do they charge?

I sure hope things work out for you. I have read your posts for a while now and your sense of humor always makes me smile. :grouphug: