I dont know if this has been discussed here yet, but I wanted to inform you all a Medicare medical review is nearly complete pertaining to official coverage of the VSG. If all goes well, we should have a peliminary decision at the end of this month (3/30/2012)! A final binding decision will be made no later than 6/28/2012.

Offical documentation can be found here....

https://www.cms.gov/medicare-coverage-database/details/nca-tracking-sheet.aspx?NCAId=258&fromdb=true

I spoke with my Bariatric Surgeons P.A. today and discussed the Medicare coverage review of the VSG. He told me based on his attendance at the annual Bariatric Surgeons convention he was told coverage for the VSG is very likley to be approved for Medicare. He did not want to cite names, but did say his information came from very reliable sources close to the review process. He went so far as to say (without prompting) "He would be shocked if the review panel rejected covering it this year".

Im starting my 6 month required supervised diet (ie Nutritionist) consultations now to be ready for submittal come October when Medicare updates it's coverage. Those of you on Medicare and Medicade who have been holding out for VSG surgery coverage I strongly suggest contacting your Hospitial's Bariatric cordinator and starting the nessicary legwork now. Starting now, I will have everything needed for insurance approval ready to go the moment coverage goes live.

~Greg

Had my Medicare VSG on October 3rd. The way it works at my hospital is they do the VSG "before" they get payment approval from medicare! Odd way of doing things, director feels I have a slam dunk case for my Medicare Administrative review and will fight for me if they prove to be stubborn.

Everything has gone very smoothly thus far, but I must say I'm already frustrated with another 2 full weeks of a liquid only diet. The head hunger is no joke, I've never wanted something as simple as a plain turkey sandwich in all my life! Everything looks so good, but I know it's completely off limits until the restriction is lifted.

I got approved today. The lady said I'd be getting another call within the next couple days to schedule surgery.

Had my Medicare VSG on October 3rd. they do the VSG "before" they get payment approval from medicare!

Greg

I know exactly what you mean with above statement

had my sleeve 12/15/11 - - been on disability retirement past 5 years since i was 53 - thus medicare. BCBS is my secondary from my office.

dr.s office told me they didn't accept Medicare, but my paperwork would have to be sent to them after WLS - they would then automatically deny, then send to my dr.s office (wasn't covered at all last year) then my dr.s office would submit to my 2ndary BCBS - who does cover the sleeve - i was a good candidate because my BMI was 40, and i had diabetes, HB, sleep apnea

so..............i had to have the WLS without being "officially" approved - without knowing for sure if i was covered

i did feel pretty safe that i'd be covered so i proceeded to be sleeved

2 months PO, after all paperwork was sent here and there, I was approved by BCBS - WooHoo

fast forward.... from DOS 12/15/11 weight 235, i'm down 90 lbs to 145 lbs WooHoo

i look and feel great - been stalled past couple of months, trying to loose 10 more lbs so i can say i lost 100 lbs!!!

wish medicare could have accepted me to begin with - but i'm glad they are joining the 21rst century and now working with the sleeve too for you NEWBIES - good things DO happen to those who wait.

God Grant me Patience, Just Hurry About It

I was scheduled for surgery tomorrow and just got a call from my Dr. saying medicare decided to to cover it. He tried to talk me into a R&Y Bypass, but I'm not doing that. Good luck to everyone else, my journey here is over!

UHC Community in NJ covered my sleeve, it was done October 16th one week ago and I'm soo thankful!!