Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Lap-band surgery and medicare


Guest aandlrivera

Recommended Posts

Guest aandlrivera

I am researching having the lap-band surgery done but am on Medicare. Has anyone had medicare approve this procedure?

Share this post


Link to post
Share on other sites

ooooo, ooooo, good question. My dad is on Medicare, I am fairly certain it pays for banding, but how much does it end up being out-of-pocket? That was his question. If Medicare pays for ALL of it, he might consider it. He's around 275, age 66 and REALLY needs to take off the weight. I'm anxoius for replies, too!

Share this post


Link to post
Share on other sites

YES, Medicare paid for my band! :) Not all but a very good portion of it. I had NO problem getting approved and they have not turned down anything. Not even my fills. :D

Out of my pocket I have paid about $1,000. Not all at once but 20 here or 20 there.

I am on Medicare because of a spinal disability.

Share this post


Link to post
Share on other sites

Hi Do you know what medicares requirement is? BMI? Docmumentaion of diet?? Extra diseases like diabetes??

tHANKS

Share this post


Link to post
Share on other sites

I called Medicare for two weeks streight evry ten minutes it seemed to they gave me this answer this is for wi they would only pay for Gastric by pass and the Roux-en-y only

also had to go see a shrink Docter for your head also six mounth of monitored weight loss with your docter or diet technician and have a bmi over 40 or other health factors.

Good luck Keep on trying every case is different/he who crys the loudest gets heard.

Share this post


Link to post
Share on other sites

HI thanks for all the replys. I called to today and she said that my dr would know how to send in the paperwork to get it covered.

All I know is that medicare a few months ago took the wording OUT of the "policy" stating that obesity isn't considered disease. I think I will call obesity clinic that do the surgery and ask them!?

Thanks,

Rene

Share this post


Link to post
Share on other sites

Wow I really don't know what Medicare's requirements are. I went with my Dr.'s requirements and didn't really think about Medicare's. I quess my Dr. and Medicare have the same requirements because I was aproved right away.

BMI 40 or over or 2 other health factors.

documentation on ALL diets I have been on for as far back as I can remember, how much I lost on those diets and how much I gained back. (ALL)

I did not have a 6 month monitored weight loss with a Dr.

I had to go to large group seminars and then small group ones.

Yes I had to see a shrink (only one time)

Then one appt. with a nutritionest.

I think that was about it other than all the pre-op testing.

Good luck, I hope this helps.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 0 replies
      1. This update has no replies.
    • 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.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×