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Awaiting final medicare approval

SuperFab

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SuperFab    689

SuperFab
Posted

Well, I've jumped through every hoop and here I am, waiting on that final approval. Once it is approved I have my appointment to see my surgeon again and pick my date. Kinda freaked out, but super excited.

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follmerpa    35

follmerpa
Posted

Did you have to wait six months? I have a Medicare thread started too, I have Medicare because of disability, I also have sleep apnea and a BMI over 50. Im worried about out of pocket and what hoops you had to jump through.

Thanks paul

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SuperFab    689

SuperFab
Posted

No, I just had to attend a seminar, see a physical therapist once, a psych once, go to a support group meeting and have 3 nut appointments. I also had a sleep study and stress test done. Those were per my regular physician, but my surgeon asked for a copy of the results. Medicare has a $1184 deductible. But I also have Medicaid, which I was told would cover that as a secondary insurance. With Medicare it's not a 6 month wait.

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SuperFab    689

SuperFab
Posted

Also I have a 45 BMI, HBP, severe spinal stenosis and just got a CPAP yesterday. Apparently I have severe sleep apnea. On their scale a 15 is mild apnea, a 30 is moderate apnea and anything over a 35 is considered severe. I was 85!!!

So I definitely have comorbidities.

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BabySheldon    158

BabySheldon
Posted

Well, I've jumped through every hoop and here I am, waiting on that final approval. Once it is approved I have my appointment to see my surgeon again and pick my date. Kinda freaked out, but super excited.

Good for you sweeetie... You have worked very hard and you deserve it!

Sheldon

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SuperFab    689

SuperFab
Posted

Good for you sweeetie... You have worked very hard and you deserve it! Sheldon

Thank you!! I'm sorta at that "am I making the right decision" phase that so many people go through... But I know I am. I'm ready to feel better physically and hope this weightloss will ease my back pain.

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follmerpa    35

follmerpa
Posted

Sounds like your well on your way to a NEW you. Thanks for answering my questions your a big help. I will be on the phone with Medicare tomorrow and get the ball rolling. Is Medicaid a good supplement to Medicare? Im new to Medicare and have a thousand questions for them.

Thank you

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SuperFab    689

SuperFab
Posted

Sounds like your well on your way to a NEW you. Thanks for answering my questions your a big help. I will be on the phone with Medicare tomorrow and get the ball rolling. Is Medicaid a good supplement to Medicare? Im new to Medicare and have a thousand questions for them. Thank you

Yes, Medicaid picks up the costs Medicare doesn't cover and also pays your monthly price for Medicare. So I don't have that coming out of my disability check Bc Medicaid pays for it.

I'll help in any way I can. You can pm me if u need, April

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eyoung    47

eyoung
Posted

Yes, Medicaid picks up the costs Medicare doesn't cover and also pays your monthly price for Medicare. So I don't have that coming out of my disability check Bc Medicaid pays for it.

I'll help in any way I can. You can pm me if u need, April

We r in the same boat April! Same insurance down to the same hoops.. I do not have sleep apnea tho. I just the nut today and waiting on the final approvals. Dont ya just love this waiting game. . It sucks! Lol

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SuperFab    689

SuperFab
Posted

We r in the same boat April! Same insurance down to the same hoops.. I do not have sleep apnea tho. I just the nut today and waiting on the final approvals. Dont ya just love this waiting game. . It sucks! Lol

Lol. It's killing me!!!! I'm on pins and needles now. It'll be a waiting game. Me waiting for that call telling me everything is good to go and then I'll finally be able to relax.

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SuperFab    689

SuperFab
Posted

That was an asshole thing to say

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SuperFab    689

SuperFab
Posted

Maybe you should think before you make a smart ass remark like that. These types of surgeries aren't for vanity reasons. They are medically necessary. I was in an accident on ice and subsequently acquired severe spinal stenosis when my hip was injured. Couldn't walk for over a year unassisted. At that time I wasn't overweight and was very physically active. Having to be sedentary caused me to gain over 140 pounds. In 2 years. Then I developed HBP and severe sleep apnea Bc of that weight gain. This surgery could actually help me to lose enough weight that it may take the pressure off my spine and allow me the opportunity to get off disability. You can kiss my fat ass

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longtimecoming7    390

longtimecoming7
Posted

Super,

You owe NO ONE an explanation! EVER! You do you, and never mind the ignorant people!

Merry Christmas!!

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SuperFab    689

SuperFab
Posted

Super, You owe NO ONE an explanation! EVER! You do you, and never mind the ignorant people! Merry Christmas!!

Thank you, the ignorance of some people is astounding. I truly hope that poster is never in any type of accident that puts him or her in a wheel chair, using a walker or in need of disability the they actually EARNED BY WORKING AND PAYING THEIR TAXES like happened to me. It actually hurts to be judged when nobody knows your story.

Merry Christmas to you as well.

April

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Go To Topic Listing Tell Your Weight Loss Surgery Story

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    • LeighaTR

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      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

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      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!
      · 1 reply
      1. Selina333

        Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

    • Alisa_S

      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

        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

      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

        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

      CaseyP1011

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

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