65 and over

[toler48 120]

Thanks! I'm pretty much decided on the sleeve, from all the research I've done and people I've talked to. I've also watched a lot of YouTube, even the actual surgeries. All very interesting.

I'll need to depend on support from my daughter and friends, sadly my husband isn't very supportive. His loss.

My insurance is Medicare and UHC. When I have my doctor appointment, which I need to make tomorrow, his office will file for pre-approval (I'm supposing this is how it works).

I just hope I don't have to wait 6 months for the surgery.

Cathy

[Cococat 119]

toler48:

Medicare paid for the Sleeve that I got. I had three co-morbidities, including high cholesterol, high blood pressure and sleep apnea. There are others which you can research by Googling Medicare Gastric Surgery (or something similar). All must be diagnosed and established as being a threat to your health... which they are.

Interesting to note: My doctor made a point of saying that Medicare will indeed pay for a Gastric Band, but if you run into trouble or are disappointed in it (it sometimes requires many adjustments and can cause erosions and scarring), although Medicare will pay to have it removed, Medicare will NOT pay for another subsequent procedure like the Sleeve or the Bypass to relpace the Band. That sort of made up my mind for me. I figured that with the rate of complications and disappointment with the Gastric Band I was better off just getting the Sleeve. I have been happy with my results of my Sleeve. Cholesterol down. Blood pressure down. Incontenence practically gone. sleep much better. The sleep doctor said that my CPAP machine gives me more oxygen for healing and energy, too.

You may have to wait for several months for surgery. You have to get a psychological clearance from a licensed professional, which undoubtedly your surgeon can refer you to. He undoubtedly works with a few psychologists on a regular basis.

Ask your surgeon what OTHER qualifications you must have. Ask his staff and his office people, since they put through the paperwork to Medicare and know the details even better than the doctor.

At one point I had to put down on paper information for Medicare - of a track record of diets and programs that I have participated in within the last 5 years. Atkins. Jenny Craig. Weight Watchers. Dieting and exercise on your own. Physician's prescribed programs of whatever diet doctors are around, etc. Things like that. Easy. I had been on every diet known to man.

I had to see sleep apnea doctors, get cardio and pulmonary clearance (all pre tests paid by Medicare), got everyone to get onboard and all my ducks in a row. My surgeon's office people were very helpful.

I was grateful to have my Sleeve taken care of by Medicare, although I think Medicare realizes that they will in all probability not have to pay for two knee and hip replacements, knee and hip rehab, back operations and other health issues because I got the Sleeve. I think Medicare comes out ahead by allowing a Sleeve.

Sorry that your spouse does not want HIS life changed by your getting a Sleeve to save your health and possibly your life. If Mr. Big Shot does not like the Sleeve tell him he does not have to get one! BUT, if he is stubborn and unhelpful, be prepared for him to subtly (maybe even unconsciously) try to sabotage you. Suddenly there will be doughnuts. While it would be perfect if he was onboard with your decision, it's YOUR knees that hurt. It is YOU who is unhappy when you get out of breath or can't pick up your grandchildren. It is YOU who can't bend down and put on your own socks. Tell him to F-off from everyone here on the bariatrics board. We have seen his kind before! After losing weight your knees, feet, back, hips, urinary system, arteries, heart and lungs will LOVE you. That smile on your face might upset him, but who cares? Tell him the old saying, "Happy wife, happy life." And the reverse is true, too.

[Lady1putt 24]

Hi! Please contact me at regular email:

LindaWilliams_51@msn.com. I too have Medicare as primary and a Supplement Plan F. My former Advantage Plan with UHC was not as flexible! I will be happy to share my experiences. This forum keeps going into error mode !! Tried to answer you 2 times :-) then it disappeared!

Linda 407-314-2365

[Bubbletoes 124]

I'm so happy to find this group so I don't feel so alone in my final Quest to do something serious about my weight. This board doesn't seem to be very active right now but maybe we can change that. Senior Sleevers, unite! By the way, I'm 64 and my sleeve is scheduled for May 4, 2015.

[reallyrosy 161]

Bubbletoes...the board is historically quiet. But when people need something specific, someone always seems to respond. I was 66 when i got my sleeve in 2011. This past week holiday brought me 10 lbs but im down 2.5 from that. Whatever, we wont steer u wrong. Its gonna be a struggle but the first year or two should be a real gift to yourself. Be determined to enjoy it!

[Cococat 119]

Congratulations, Bubbletoes,

Some of our surgeons have support groups as part of their practice. Some do not. At any rate, you will find people here who can share their experiences with you. Remember: everyone's experience is different, but some things are pretty much universal. Like: drink the recommended amount of Water and eat the right amount of Protein. Also: Keep a positive attitude. As far as "toes" go - the first thing that actually looked better to me after the operation were my feet! I had nice feet but when I got fat, my feet started to swell and look awful. I also could not bend down comfortably enough to put polish on them. Well, a few weeks post-op and my feet looked great. I can now polish my toenails easily. Ah, vanity! You will do well. This time you will be doing something for yourself, and in doing that it will benefit your entire family too.

[toler48 120]

Cococat, Oh my, painting my toenails is something I look forward to! It's been so long since I have been able to bend over and do that.

Bubbletoes, Congrats, I'm sure everything will go great! I'm just now starting the process and am hoping it doesn't take too long. Hang in there and ask for help and support whenever you need it.

[Cococat 119]

It is funny how the little things, like being able to paint your own toenails, mean so much - but it does. There are a hundred other little things that we give up when we put on weight. Is there a spiritual lesson in all of this? I hope so. I have yet to lose all the weight I want, but even as I am, I have a deep understanding of overweight people and how they suffer. So, to those who have not yet had their operation: Stay hopeful and strong. You will have an opportunity to reset your lifestyle. To those who have already had their operation: YIPPEE! You know what I mean!

[Lady1putt 24]

Welcome aboard Bubbletoes!

This group is solid and full of compassion! My surgery was April 1st.

What's that expression about..."there's no fool like an old fool" ??

I only feel foolish that I waited so long....I will turn 67 in July!

So far I have had an amazing journey. No problems to speak of that I did not anticipate! Just do your research....order samples to try to find Protein that fit your taste buds. Explore read be informed and listen to your surgeon. Let us know how we can support you!

Linda

The Villages, Fl.

P.S. So much fun watching scale go down and especially my clothes getting looser and looser! Plan to savor every glorious moment!

[*Kate* 10]

I had my gastric sleeve done last July at the age of 66. Since I live in Arizona, I checked with surgeons here and was told that Medicare didn't cover sleeves in some of the Western states, including Arizona, Californis and Nevada, except under certain circumstances - and that you wouldn't find out if you qualified until after the surgery. Medicare would, however, cover the bypass and lap band.

That sounded a bit scary so I contacted a center in Colorado and was told I could have the sleeve covered there. So off we went to Colorado where I successfully had the surgery and have now lost 85 lbs.

Question, is there still the restriction for sleeve surgery in some states? I believe it was states in the Noridian regions. It seems wrong that some Medicare patients have easier access to certain procedures.

Kate

[Cococat 119]

I can't quite get my head around the problem you had. As far as I know, MediCARE is a Federal program. I thought all Federal programs were uniform in all states. Maybe you are thinking of the MediCAID progarms specific to each individual state. That could account for the variation in coverage. Just a guess. Hey, I could be wrong. So, anyone getting the gastric procedures done- check out all the details. Dot your "I" s and cross your "T"s. I hate surprises.

[reallyrosie 5]

In ct back in 2011 i had the biggest hassle getting funded. I have medicare and anthem. i still dont know which actually paid gor it but the atty generals office from ct sent me s letter srating anthem would. This after i told the doc that i would pay for the sleeve myself! Took 2 years 2 hospitals and a letter from the first docs atty banning me from their service. Whatever...do not give up or in!

[*Kate* 10]

Cococat, I have regular Medicare plus a supplement. I was surprised about it too because I thought coverage would be the same throughout the whole country. This was information given to me by the surgeon I was seeing in Scottsdale and was confirmed by my own research. Bariatric surgeons in this Medicare region were trying to get it changed to covered and I was wondering if it has been - not that it helps me now.

[reallyrosie 5]

In ct back in 2011 i had the biggest hassle getting funded. I have medicare and anthem. i still dont know which actually paid gor it but the atty generals office from ct sent me s letter srating anthem would. This after i told the doc that i would pay for the sleeve myself! Took 2 years 2 hospitals and a letter from the first docs atty banning me from their service. Whatever...do not give up or in!

[toler48 120]

Kate, I'll be finding out about Medicare soon. I will be talking with the insurance dept here in Tucson on Tues. I'll post what I find out. I sure don't want to have to go to another state for surgery.

I would think that Medicare would cover all three main surgeries, just to prevent the health problems they would have to cover otherwise.

I am very thankful that my hips and knees have never given me any problems. It's all the other co-morbidity problems I have.