Please note that RNY surgery is covered in ALL states for ALL Medicare patients, regardless of age. They are handling surgery for the sleeve in a different way:

Medicare decided to allow the Regional Contractors make the "final decision" on coverage for the Sleeve. I don't understand how a federal program (Medicare) can have different rules for coverage, depending on where you happen to live.

Here's the deal:

26 states have sleeve gastrectomy coverage for all Medicare patients

• 7 states have limited sleeve gastrectomy coverage for age 64 years and younger; age 65 and older is excluded
  
• 11 states have limited sleeve gastrectomy coverage for ages 60 and younger; age 61 and older is excluded
  
• 6 states and Washington DC currently have NO sleeve gastrectomy coverage
  

If anyone lives in one of the 26 states that cover the sleeve for all Medicare patients (no age discrimination), please let us know! And thank your lucky stars that you live in a state where Medicare will cover this surgery.

I don't understand how a federal program (Medicare) can be administered this way- with different rules in different states. Any lawyers out there???

I am from s Ohio . I had sleeve nov 28 , 2012 . Medicare paid and I was 66 on surgery day. My surgeon did a lot of personal work to get Medicare to cover sleeve since it passed in June. It took a few months. Don't know what he did but before nov they could not get them to pay till the surgeon stepped in. I was very lucky.

My surgeon is trying to do a Medicare patient here in Pennsylvania. The first Medicare patent for them and the VSG. I was supposed to see how it went and I’d follow. Well,

They sent in the request. Over a month ago. No word. I talked to the coordinator, no word yet. She had told me that Pennsylvania is not a very proactive state. I’m not sure what that means but I don’t like it.

The word to start with was it looks hopeful, now the word is (I just don’t know) I’m disappointed to say the least.

I’m 54 now. I sure would like the surgery soon.

I’m thinking if I could supplement my Medicare with something extra would I have a chance? Where could I even get council on this issue?

Ahhhh.

Well, my surgeon called me. Its looks clear, Medicare will pay. I’m singed in for the VSG surgery. My first meeting is on April 24.

This will start the process; now praying I qualify in all departments for the surgery.