This is the what one Hospital provided me for Gastric Bypass Medicare costs and requirements. One thing I noticed is "Consecutive diet counseling within 1 year of surgery" but did not specify a duration time for the diet.

Anyway, thought some might derive some useful info from this.

TRADITIONAL MEDICARE Insurance Requirements
Primary Bariatric Surgery - covered benefit? Yes
Revision/Conversion Surgery - covered benefit? Yes - BASED UPON MEDICAL NECESSITY
Special Facility Requirements? N/A
Specialty Referral or Authorization required from PCP?

● No referral required for clinic

● Policy Copay Fees

Registered Dietician (RD) ● One on One Counseling Session ● Diet Class	$0 DX: DIABETES $30
Psychology	$0
Specialist ● (Surgeon, APP/NP/PA, Cardiology, Pulmonology, Obesity Medicine Specialist)	$0

●

BMI requirements

● ‌ BMI >= 40
- OR -

● ‌ BMI >= 35 with 1 of the following:

● OSA on CPAP

● TIIDM

● HTN

●
Nutrition Education

● ‌ Consecutive diet counseling within 1 year of surgery

● Documentation includes weight, diet education, supervised by an MD

● Must meet weight goal set by Dietician to return to see your surgeon and schedule surgery

●
Psychology Evaluation

● ‌ Clearance within 1 year(s) of surgery (Special considerations may apply, to be discussed if needed)

Medical Evaluation

● ‌ Letter of Medical Necessity by ANY medical provider Yes

● On his/her letterhead

● Signed and Dated by the MD/DO/RN/ARNP/APP

● Documents previous failed attempts at weight loss

● Lists co-morbid conditions related to obesity

● Additional Medical Clearances no

Mine (I have Medicare as well as Tricare) had (this is from memory) 6 months of meeting with my primary, filling out a paper each time about whatever diet you are on, plus how much weight you lost on it. one meeting (all this before surgery) with a psych, one meeting with the dietitian, getting stomach scoped. My BMI was >35, and I had high blood pressure, so I qualified.

Medicare costs and requirements can vary depending on your specific plan (Part A, B, C, or D) and your income level. Part A is premium-free if you’ve paid Medicare taxes for at least 10 years, while Part B has a monthly premium and deductible. Eligibility generally requires being 65 or older or qualifying through disability or specific medical conditions.

Medicare expenses and eligibility criteria vary based on the plan you select (Part A, B, C, or D) and your financial situation. Part A is often free for those who have paid Medicare taxes for at least 10 years, while Part B comes with a monthly premium and deductible. Typically, eligibility applies to individuals aged 65 or older or those with qualifying disabilities or medical conditions.
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