Hi, I might be able to help a little ...
I used Medicare/Medi-Cal to pay for my gastric bypass. The way it works is they don't pre-authorize like most insurances do. Your surgeon bills the insurance AFTER he/she operates on you. So what I needed was a list of my medical problems, meds, family history, blah, blah, blah ... but the most important was a list of diets I've been on (detailed list) plus a long letter from my primary care physician explaining why the surgery would benefit me. Your PCP has to include info like you have been morbidly obese for at least 5 years ... that diets have failed ... that your medical problems are severe enough to warrant the expence of the surgery ($25,000). I have had my doctor for the last 12 years and is very supportive of the surgery, so he wrote me a wonderful letter, I was very lucky. You will also need a psych eval. and that is because the state of California requires it. No exceptions. Unfortunately, Medicare nor Medi-Cal will pay for it, so you must pay cash out of your own pocket. I paid $150.00 for this. But that was the ONLY out of pocket expense I had, so I can't complain at all. You are NOT required to do the 6-month diet, or liqiod diet, or any other special diet before-hand. Your surgeon may require something like that, but your insurance does not.
Hope this helped.
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OPEN RNY: 03/06/08
OPEN HERNIORRHAPHY: 09/18/08
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