Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

I have primary coverage through Cigna, with Medicare as my secondary (on disability). I originally was going to have to go through all of the insurance criteria, but because I need to have a previous nissen fundoplication for a hiatal hernia repaired, my doctor was going to be able to do both at once and consider it a revision, bypassing all the insurance requirements. I got my surgery date set at June 30. I did my 2 week pre-op diet, my mom bought a plane ticket to come help with the kids, husband took off work, yada yada yada. Then, last WEDNESDAY, just a few days before my surgery, the surgeon's office called to tell me the surgery center canceled my procedure because they found out I have Medicare.

Um. Did they not do their pre-cert process? Why did they wait until the last freaking minute to tell me? I'm crushed. I know it will still happen, I just have to go the longer bariatric coverage route, but it just sucks. I was completely mentally prepared for it and I feel like I got the rug pulled out from under me. UGH!

Share this post


Link to post
Share on other sites

I am so sorry this happened to you. My surgery was delayed bc they over booked the surgeon on that day. Like you I had mad all necessary arrangements for the family. Mine was only pushed out a week but I understand your frustration. It will happen we just have to stay focused and remember the reason why we are even doing this to begin with.

My fingers are crossed that the process goes quickly!

Good luck

Share this post


Link to post
Share on other sites

This is a huge deal and I know all the preparations that I went through(emotionally/physically/mentally) and I would be devastated to have experienced that. I am so sorry and hope things go more quickly and smoothly than you expect! Good luck to you!

Share this post


Link to post
Share on other sites

If medicare is your secondary coverage why did they cancel? That's not clear. They'll just pick up the costs of copays and deductibles after Cigna.

Share this post


Link to post
Share on other sites

If medicare is your secondary coverage why did they cancel? That's not clear. They'll just pick up the costs of copays and deductibles after Cigna.

They said it was because they don't accept Medicare at all, so they didn't want me to try and run a claim through afterward. I said I'd sign a waiver or whatever they wanted, but they refused. Medicare doesn't even have bariatric coverage, so it's not like they'd pay anything anyway! I was livid.

Share this post


Link to post
Share on other sites

They said it was because they don't accept Medicare at all, so they didn't want me to try and run a claim through afterward. I said I'd sign a waiver or whatever they wanted, but they refused. Medicare doesn't even have bariatric coverage, so it's not like they'd pay anything anyway! I was livid.

Sounds like bs to me

Medicare does pay for bariatric though I've seen several posts from those 65+ who have had surgery pd for by medicare

Did they offer you a secondary location?

Share this post


Link to post
Share on other sites

Really? I was told they didn't cover bariatrics. Interesting... Yeah, now that I'm going the traditional bariatric route, I can have it done at a hospital, so there shouldn't be any issues. Ha! Right! ;) Fingers crossed, anyway.

Share this post


Link to post
Share on other sites

Well tell the hospital to file any copays you may have to medicare. Can't hurt to pick a little something up for you

Share this post


Link to post
Share on other sites

I looked at that last night, but saw this:

C. Nationally Non-Covered Indications

The following bariatric surgery procedures are non-covered for all Medicare beneficiaries:

Open adjustable gastric banding;

Open and laparoscopic sleeve gastrectomy; and,

Open and laparoscopic vertical banded gastroplasty.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
    • RacMag  »  bhogue925

      Hi, I’m new here. I’m currently on the liver shrinking diet. So far so good, but I have to say I haven’t found a protein shake I like. Anyone have any suggestions please? My surgery date is September 17th. 
      · 2 replies
      1. BlondePatriotInCDA

        Fairlife Core are by far the best. They taste just as they are - chocolate milk. You can either get the 26 grams or the 42 grams (harder to find and more expensive). For straight protein look at Bulksuppliments.com ..they have really good whey proteins and offer auto ship plus they test for purity. No taste or smell...

      2. BlondePatriotInCDA

        Fairlife has strawberry, vanilla and of course chocolate. No more calories than other protein drinks. Stay away from Premiere, they're dealing with lawsuits due to not being honest about protein content.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×