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New Medicare Rule! Can"t Get My Fill!

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.

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UPDATE:

I GOT A FILL TODAY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I went to see my original surgeon today for a follow up and he gave me a fill in his office! He said he normally does not do this as most of his patients are not on Medicare (or can afford the out of pocket).

How nice of him was that??

I said to him at the begining of the visit "I researched surgeons for over a year and chose you for a reason. I'd hate to have to go to someone else". And that was the god's honest truth.

Awesome.

Questions:

I have 1.5 cc's in a 4 cc band. I'm on liquids for a day. Tomorrow full liquids right?

DOes restriction kick in right away?

I went to the beach afterward to swim. That won't hurt the puncture will it? Infect it? I didn't even think of it till now.

Yay you got a fill!!!! Congrats!

have 1.5 cc's in a 4 cc band. I'm on liquids for a day. Tomorrow full liquids right? full liquids or soft mushies...take it slow. some folks go ahead and follow the post of diet as long as possible if the limited intake and liquids jump start the weight loss...up to you, just go slow.

Oh, just thought about your post-op swelling issues...reaallllllly take it easy and be careful.

DOes restriction kick in right away? some folks don't feel a thing till 2 weeks out. ??? You should feel a difference the first time you eat food with substance. Look for the ever so slight chest pressure, then don't take another bite till it goes away.

I went to the beach afterward to swim. That won't hurt the puncture will it? Infect it? I didn't even think of it till now. Probably not, not with salt water. Keep the puncture clean and dry. Maybe dab a tiny bit of antibiotic ointment on it at bedtime. Should be fine.

Yay Leener! Let us know how it goes!

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Thanks Lisa! :-)

I appreciate your support and I don't know what I would have done if it weren't for the people on this board.

Congratulations, leener! I knew they'd come through for ya. ;-)

Take it slowly on eating; you never know when restriction will kick in or whether you'll have swelling in response to the increased tightness. Everyone is different so PAY ATTENTION to your body's signals. Welcome to bandlandia!! :clap2: :clap2: :clap2:

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