Medicare question - ThinnerTimes

PattyA · 05-19-2008, 09:08 PM

Hello all...I will be on Medicare starting June 1 and wondered if anyone knows the requirements to get approval for bypass surgery? I have been on the Medicare web page and so far I haven't found any answers. I will be going to see Dr. Shinn in Charleston, WV on June 17th for the first time. (I've already seen the nutritionist who suggested I go on a 1200 cal. diet which I'm trying to do faithfully). The office says that they require the 6 month physician supervised diet and 100 lbs overweight. Thanks for any information!

KyMama56 · 05-19-2008, 09:34 PM

Hi Patty

I had my surgery under Medicare. I never had a PCP, I only went to a Weight Loss Surgery Seminar in Lexington, Ky. It all just snow-balled from there. The Bariatric Clinic there told me when to come back for all my appointments and took care of all the correspondence with Medicare. I was only out $375.00 so far. Haven't received any other bill yet. Hope this helps.

Godsblessedme · 05-20-2008, 08:46 AM

i wonder if you have to do the 6month supervised diet?

KyMama56 · 05-20-2008, 12:00 PM

I didn't have to do a 6 month diet. As I said, the center took care of everything with Medicare. I just showed up for the appointments; nut class, psych, pre-op, labs, etc. and then I was given a surgery date.

PattyA · 05-20-2008, 01:32 PM

I appreciate the information guys...I will find out more when I see the doc in June...I am so hoping that I can get approved this summer! Where are you in Kentucky, KYMamma?? My daughter lives in South Point, Ohio and we are always shopping in Ashland Ky.

timidcharm · 05-23-2008, 08:31 PM

I have a Medicare advantage HMO through Humana , the company has advised me there is NO medicare requirement for supervised weight loss program. For me it been getting the Insurance clerk to understand I dont have regular Humana since its a Medicare Advantage plan.

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bebop · 05-29-2008, 03:26 PM

oh geesh another troll?

anyway I spoke with medicare today since I will be going on it in July. the really nice helpful lady told me that the requirements are as follows. and you have to meet all 4.

bmi of at least 35
1 illness ie either diabetic or high bloodpressure
unsuccessful diets. (I did forget how long that is over)
and have it done at an approved facility

sounds pretty easy

PattyA · 05-30-2008, 08:22 PM

I appreciate all of your input! TT has been so wonderful and helps me feel connected to people who really understand the problems and emotions that happen along this journey.....its really been a blessing!! I have an appointment with the bariatric doc on June 17 for the first time.

bebop · 05-30-2008, 08:50 PM

let us know how it goes! I won't even get my medicare until July so I have a ways to go yet.