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Medicare

Can anyone who has had a lapband paid for by Medicare, tell me what part of the procedure Medicare did not pay for? :help:

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If you scroll down tot the bottom of this page, you will find some other threads aout Medicare, I hope one of these threads can help you. I don't know anything about it, but feel fairly certain that your answers are here, somewhere.

  • Author

Thanks faithmd, I will check it out. I'm real new here and trying to figure my way around.

FYI. I hope I am wrong but I thought I let you know what I heard. I was told (in NJ) that Medicare is fast at approving and all is covered. However, Medicare may be discontinuing coverage for the bariatric surgery altogether. So if you have medicare, find this out in your state to see if true and get the process rolling as soon as possible. I don't know about Medicare but one of the people in my group consultation has it and the Nurse suggested she make a decision soon about getting the surgery because she heard of the discontinuation. She said they are fast at approving too. Good Luck.

  • Author

bbjerseygirl, Thank you. I'm going to be a self pay, but my husband is going through Medicare. It looks like it takes about 6 months for him. He needs a lot of documentation from his doctor. Has to go for psych eval, nutritionist....etc. I was trying to find out if anyone has had it done and how long it took them and what they paid. I haven't heard anything about Medicare dropping the procedure, though. Anyway, thanks for your time, I appreciate it.

My Medicare paid everything..And also the first 3 fills. I am from Texas. I do not know how other states work it out...

Serisla,

Did you have a gapfiller policy that paid the remainder? My supplemental policy that costs $416 a month (through my former employer) has a WLS exclusion. I am responsible for $996 plus the $500 program fee.

Serena,

I also have Medicaid.They picked up the remaining balance. But after the 3rd. fill, I have to pay full price because neither medicare or medicaid pay. My doctor charges $80.00 for fills, for patients who have medicare and/or medicaid.

Serisla,

That's awesome that you have had no out-of-pocket expenses until now. I'm still annoyed that my very expensive supplemental insurance won't pay a dime....

I'm from Cincinnati, Ohio. I'm guessing that you're from Pennsylvania.

I live in Chicago,IL medicaid/medicare will not pay for the Lap band here only bypass...

Serena,

Sorry to hear about your insurance. No, I am not from Penn. I'm just a huge loyal fan of the Pittsburgh Steelers...I am from Texas.....

Jessie45,

Try asking Medicare/Medicaid that if you had lap band surgery in Texas, if they would pay for it...Give it a try.......

Thanks, But I have UHC Choice....I hope they pay for it...My appt is 7/28..I cant wait!

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