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

medicare ins.


Guest betty240

Recommended Posts

Guest betty240

has anyone had medicare to pay for the surgery

Share this post


Link to post
Share on other sites
Guest betty240

Hi my dr. says that there should be no problem I haven't heard anything as of yet it has been 3or4 weeks I also have blue cross / blue shield when I hear anything definiteI will get back to you Betty

Share this post


Link to post
Share on other sites

I've heard that medicare does indeed pay for the band, and precertification isn't even necessary. I guess they determine whether it was medically necessary when the claim is submitted.

Your doctor is probably the best resource for this information. If precert is not required, there'd be absolutely no way to get an assurance that it will be paid for. If you are 100% that you qualify medically, there shouldn't be a problem, but that's where your doc's expertise is crucial.

Share this post


Link to post
Share on other sites

I have Medicare and they paid for my surgery and for Dr. visits, nutritionist, phyc. eval, the works. No pre qualify. of course they paid the 80% and I paid 20%.

Share this post


Link to post
Share on other sites

:) Medicare and my Medi-Gap insurance paid for everything. I met the weight and BMI requirements. I was NOT required to have a psy. exam, sleep exam, nutrition counseling, etc. I had had a recent stress test so did not have to repeat that either.

I was approved in 3 days. My surgery was scheduled 8 days after my consultation with my doctor. I was given tons of reading material and had been on the internet for months doing research.

Hope this helps,

has anyone had medicare to pay for the surgery

Share this post


Link to post
Share on other sites

If you google medicare lapband it will say that medicare is researching the band and doesn't cover it yet. This was a big deal months ago when medicare deleted obesity isn't considered a disease. It was on CNN and CnN announced medicare is considering covering it and they were supposed to have an answer after 5 month review.

I called a major lapband office in San Francisco and she said no medicare doesn't cover it and spoke to medicare offten. She did say doctors can fudge on the coding and get it covered but their office doesn't do that. I also called Sacramentos lapband offices and got the same thing.

Both lapband offices said that medicare will pay for the hospital part (a few thousand?) and that I'd have to pay for the surgeons fee. So you can save a little that way.

Share this post


Link to post
Share on other sites

My girlfriend had Medicare & they covered her lapband & all her fills 100% - she was approved in less than 2 months from start to finish.

Share this post


Link to post
Share on other sites

I have Medicare and state Medicaid. I was approved for surgery in less then a month. Medicare at this point has no prequalifications for approval. However there are very little doctors that will do the surgery with this insurance because they only get paid the very mininum for this procedure, so they will tell you Medicare doesn't cover. But it does.

Share this post


Link to post
Share on other sites

That's great that medicare paid. Do you know how much medicare paid to the hospital and how much medicare paid to the doctor??

Share this post


Link to post
Share on other sites

Medicare paid 80% of the surgery cost - 75% of pre op requirements - 90% of post op care (including fills even under fluro). Because I also have medicaid, they paid the remainder of the bill/costs.

Share this post


Link to post
Share on other sites

I am trying to get approved through Medicare and if you hear anything about it could you tell Me?

Thank You

Hi my name is Linda and I also am on medicare, I live in Fl. I called my surgeon, my first appt will be May 19th, I was told that medicare does pay for it if I meet all the requirements, and that if I have co medical obesity issues, which I do so I am very excited to meet my Dr and find out for sure what will take place next. Have you had your 1st visit with the Surgeon yet. Thank you, Linda:tongue:

Share this post


Link to post
Share on other sites

I had my surgery in 2006. Have had a Tummy Tuck and currently weigh 133 pounds..Medicare paid and what they didn't Tricare (military ins. picked up) I have had a good experience except for early days when eating out. I felt deprived but have since gotten over all that. I now know how to handle my self like a pro. My doctor just saw me for an anniversary checkup and he was thrilled with me and my weight. I don't expect any problems and have had none in the past. Hope this helps!

Sandy

PS I lived in Sarasota since 1987 and moved to minnesota in 2003.

I am very pleased with my band and would recommend to anyone.

I should post a new photo. I do look pretty good now at 62 Years Old

PSS: I had High blood pressure, sleep apnea, high cholesterol, depression, just had a bit of trouble with getting through the psych appt. but finally made it. The first pscyh Dr. was being extremely careful. The second one I got much more comfortable with her so made it in a couple months.

Edited by Sandybells

Share this post


Link to post
Share on other sites

Hi my name is Linda and I also am on medicare, I live in Fl. I called my surgeon, my first appt will be May 19th, I was told that medicare does pay for it if I meet all the requirements, and that if I have co medical obesity issues, which I do so I am very excited to meet my Dr and find out for sure what will take place next. Have you had your 1st visit with the Surgeon yet. Thank you, Linda:tongue:

Hi Sandiebell, I go today to talk to my sergion will let you know what he says when I get home.:w00t:

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

    ×