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From Florida, Medicare approval process for sleeve

Hi I'm new here! Hoping to have my sleeve in October 2016.

Anyone from Florida? Has anyone here had to work with Medicare for approval for the sleeve?

What was your criteria and whole process you are or had to go thru?

I want to make sure I have my ducks in a row.

Thank you and have a blessed day!

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  • tamatoot12699
    tamatoot12699

    Hi, I do have fatty liver disease. I just found out about my sugar and high cholesterol, so I have started meds. I have proof of sleep apnea and my sleep Dr wrote a letter for me , so did my primary.

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Florida here. At 66 Medicare approved my surgery, with three co morbidities, asthma, HBP, and diabetes. I weighed 210. The staff of our Bariatric surgeon took care of everything dealing with Medicare. We paid $500 out of pocket. We just had the sleeve, Doctor and staff did the rest. Find a Seminar and get started! Best thing we ever did for ourself, the health problems have gone mostly.

  • Author

Hi, thank you for your reply. I'm 46, 5'9 and my BMI is 37.9 not quite 40. What all did Medicare what you to do before the surgery or did they didn't require anything because you have three comorbidities?

I have obstructive sleep apnea, just found out my sugar is prediabetic, I have fatty liver disease and my cholesterol is a little high. I've been on nurtrosystem for about 6 months under my pcp before that it was weight watchers. I have lost weight, I've gained.

I just want to have all my ducks in a row. Any help you could provide would be awesome.

I believe most insurances will not accept "pre" diabetic or high cholesterol as a comorbitity. Are you on medication for these??? All of us obese have fatty livers. That is why they put us on a liver shrink diet pre surgery. They will want proof of your sleep apnea, sleep study.

Sent from my SM-N910T using the BariatricPal App

At 46 you are on Medicare???? I think it is pretty standard, that you attend meetings prior to surgery, see a psychologist, visit a nutritionist, and do the liver shrink diet. My surgeon had all these people at his offices and on staff at the hospital. Pretty simple.

  • Author

Hi, I do have fatty liver disease. I just found out about my sugar and high cholesterol, so I have started meds. I have proof of sleep apnea and my sleep Dr wrote a letter for me , so did my primary. I have degenerated disc disease in my lower back, so most of my dr have written letters. My Medicare requires a BMI of 35 or greater, one comorbidity, and documents showing failed medical supervision weight loss. I have all of that but I'm seeing that each one who has Medicare has had do something different than the other. Maybe it's state related. My Medicare is thru SS disability. I called Medicare and the above is what the told me I needed.

Sounds like you'll be good to go

Sent from my SM-N910T using the BariatricPal App

My husband's sleep apnea and machine went away after the sleeve, his low blood sugars stopped, he is off some of his many blood pressure meds, and his insulin use was almost cut in half. The benefits of the sleeve have been amazing. I came off Metformin, we both have a healthy A1c, my asthma is controlled, my feet stopped swelling, I am not out of breath walking a block. I hope you qualify and get healthy!

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