What does medicare need for approval... - ThinnerTimes

PattyA · 05-01-2008, 02:01 PM

Hi all! I was supposed to see the doctor, nurse and dietician today at my first appointment at bariatric center but the doc was called out on an emergency. I have to wait 6 wks to get another app. with the doc. My insurance changes from private to Medicare on June 1st so I'm wondering what documentation Medicare will want to approve the surgery. My referring (primary care doc) wrote a letter of referral to the weight loss center stating, in letter form, how I have tried to lose weight without success for the last two years. The bariatric center said thats not want they want..they want monthly documention with more specific info, ect. Has anyone out there had experience with Medicare? I was disappointed that I didn't see the doc today but I think I was expecting things to move like clockwork and get my surgery date earlier...uh...I think I made a mistake thinking things would go quickly and smoothly!! At least I saw someone today and the ball is rolling ...slower than I thought...but I'm still happy!

timidcharm · 05-23-2008, 07:41 PM

Im dealing with a Medicare HMO and with them you just need to be BMI 40 or 35 with comobitiy like high blood pressure or diabetes, or high cholesterol.

sherry7 · 05-26-2008, 09:27 PM

At my support group meeting last month, someone mentioned Medicare approval. My memory is foggy because I was not paying much attention, but I believe they said that WLS is approved without a 6 month pre-op waiting period if you just have regular Medicare. However, if you have one of the Medicare add-on insurances, a 6 month pre-op waiting period is required. That being said, I don't know if the full cost is covered by 'regular' Medicare. Don't take this information as gospel, but I was 'zoning out' while this was being talked about because I don't have Medicare.

You'd probably get more responses on this if you reposted it in the Insurance section, instead of in this section.