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Medicare....No approval needed?



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I was just wondering if anyone else has Medicare. My doctor's office has said they don't have to submit for preapproval, Medicare will automatically pay for it.

I am kind of nervous about that.

Anyone else???

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Yes they do.

So relax your mind about it.

Take care of yourself and prepare for surgery.

Good luck.

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I have to have a 6 months of medical visits with my Primary before they can send in everything. This is in North Carolina, I guess all states are different

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I have to have a 6 months of medical visits with my Primary before they can send in everything. This is in North Carolina, I guess all states are different

I live in KY and I have to do that too... I was wondering if they still do the surgery after the 6 months or what. My first appointment with them is monday and I don't wanna ask lol

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In Arkansas you have to jump thru all the hoops too. That's why I didn't use it for my surgery. I just used my husband's insurance.

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Medicare does vary a bit from state to state. I live in California, and here they do not pay for the Sleeve, so I am having the Gastric Bypass. But the people are right. Good luck.

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I have Medicare as my Primary and Medicaid (United Health Care) as my Secondary, so your telling me you can just go to a surgeons office and start the process of seeing him and go to psych eval, and all that and surgery without Medicare's approval, I don't know that makes me nervous to think that will fly without in the end you ending up with huge medical bills for not getting some kind of authorization. I have Medicare but right now my referral coordinator is working on my paper work to submit it to Medicare and Medicaid, so look like in Michigan you need some sort of pre-authorization

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You are getting away too far ahead of yourself. Surgeons, and their respective hospitals, do not do this surgery unless they believe they are going to get paid. There are requirements. It isn't like going to Macy's and buying a blouse. The surgery has to be at a Bariactric Center for Excellence. (that is a medical qualification system or sorts) You do have to jump through hoops like seeing a psychiatrist, etc., but Medicare isn't as difficult as some. You need a referral from your PCP, you have to meet the BMI and other requirements. I strongly suggest that you get the referral, and speak with a surgeon. They will take care of the approvals, not you. Like I said, they want to get paid. Good Luck.

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    • LeighaTR

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    • 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

        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

      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

        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

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