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FOR THOSE WHO HAVE MEDICARE ADVANTAGE PLANS

Medicare covers bariatric surgery and by law all Medicare advantage plans MUST cover everything Medicare covers and they CANNOT tack on a bunch of requirement criteria that Medicare doesn't have. Your bariatric clinics insurance coordinator can help you navigate all this because trust me the insurance company is usually of little help. Most of the time they don't want to even admit to you they cover it.

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  • I have AARp. A lot of hoops to jump through, but I'm almost to surgery.

  • lifeasfaith
    lifeasfaith

    There are SOME hoops to jump through... But nothing more than what Medicare requires. Congratulations! I'm almost there myself!

  • I was finished with my last nutrition on Nov 20th. It took them 4 weeks to send 4 approval and it was approved the same day. Another 4 weeks and and I'm still waiting for a call to get my date. I got

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I have AARp. A lot of hoops to jump through, but I'm almost to surgery.

  • Author
I have AARp. A lot of hoops to jump through, but I'm almost to surgery.
There are SOME hoops to jump through... But nothing more than what Medicare requires. Congratulations! I'm almost there myself!

I was finished with my last nutrition on Nov 20th. It took them 4 weeks to send 4 approval and it was approved the same day. Another 4 weeks and and I'm still waiting for a call to get my date. I got a questionnaire from the hospital about 9 days ago, so I'm hoping Amy day now. Where are you at with yours? I started this over 7 months ago and was told by the Dr my surgery would be the end of December or early January. At this point, when I get the call it will be another 4 week wait, so maybe March? Good luck I hope you don't have to wait much longer!

  • Author
I was finished with my last nutrition on Nov 20th. It took them 4 weeks to send 4 approval and it was approved the same day. Another 4 weeks and and I'm still waiting for a call to get my date. I got a questionnaire from the hospital about 9 days ago, so I'm hoping Amy day now. Where are you at with yours? I started this over 7 months ago and was told by the Dr my surgery would be the end of December or early January. At this point, when I get the call it will be another 4 week wait, so maybe March? Good luck I hope you don't have to wait much longer!
I sent in my first application to see if they would even accept me into the bariatric program on Dec 18th 2018 (they accepted me 4 weeks later) and I will have my last appt March 5th 2019 and ready to submit to insurance. It will take up to 30 days for insurance to approve so I'm looking at an April Surgery. So from Start to surgery day it will be 4 months roughly.

I had to do 5 nutrition appts. My first one immediately after my first visit, then once a month for 4 months. I did blood work, ekg, Dr letter confirming support amd a psych evaluation, which I paid cash for, because medicare was so hard to find a Dr through. You are right about the advantage plans carrying bariatric surgery. They have to cover it. I'm on disability and very happy they cover it, as my insurance nor my husbands never covered it.

  • 4 months later...

I have uhc complete choice ppo and they have told my surgeons office (on more than 1 occasion) that no prior authorization is required because Medicare doesn’t prior authorize RNY? Really? Basically their refusing to do a prior authorization. She couldn’t even submit it online. Have any of you had this happen. I have to sign an ABN ?

Refresh my memory---what is an ABN? Surely it is is something I will have a "face-plan" moment over this. " Thud---YOU SHOUKD HAVE KNOWN THIS ALREADY!"???

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