Kat Can

Medicare and Oregon Weight Loss (Dr Emma Patterson)?

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Hi all!  I'm just starting out with the process, and was wondering if anyone here went to OWLS in Portland, OR, and was on Medicare?  I'm just curious as to what your time frame was?

 

Thanks!

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thanks, no, but I am on the last hurdle before seeing the surgeon :D

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I am on Medicare in Texas and have not yet had my surgery but the doctor I am seeing told me at the beginning it was 3 months, (90 days or more.)  Be sure when you do your program you confirm that because I have read of one person who was 1 day short and had to do a whole extra month to get her surgery approved. I have my last nut visit in June and technically it is the 4th visit but it will be 91 days exactly.  I have had my cardio clearance, and the endo is the one giving me a bit of a problem.  She wants my sugar to be at a good level???? Hello that is why I am doing this, to hopefully have the diabetes and high blood pressure improve and the weight loss will be awesome.  To be able to not look pregnant at the age of 66 will be awesome.  What I do not know is whether Medicare is the same throughout the states or does it differ state to state?  Good luck on your journey.  I am so ready. 

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I am on Medicare in Texas and have not yet had my surgery but the doctor I am seeing told me at the beginning it was 3 months, (90 days or more.)  Be sure when you do your program you confirm that because I have read of one person who was 1 day short and had to do a whole extra month to get her surgery approved. I have my last nut visit in June and technically it is the 4th visit but it will be 91 days exactly.  I have had my cardio clearance, and the endo is the one giving me a bit of a problem.  She wants my sugar to be at a good level???? Hello that is why I am doing this, to hopefully have the diabetes and high blood pressure improve and the weight loss will be awesome.  To be able to not look pregnant at the age of 66 will be awesome.  What I do not know is whether Medicare is the same throughout the states or does it differ state to state?  Good luck on your journey.  I am so ready. 

 

On the medicare/medicaid website (http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=57&ncdver=5&bc=AgAAgAAAAEAAAA%3d%3d&), it states:

 

D. Other

Effective for services performed on and after June 27, 2012, Medicare Administrative Contractors (MACs) acting within their respective jurisdictions may determine coverage of stand-alone laparoscopic sleeve gastrectomy (LSG) for the treatment of co-morbid conditions related to obesity in Medicare beneficiaries only when all of the following conditions a.-c. are satisfied.

a. The beneficiary has a body-mass index (BMI) ≥ 35 kg/m2,

b. The beneficiary has at least one co-morbidity related to obesity, and,

c. The beneficiary has been previously unsuccessful with medical treatment for obesity.

 

No where in there did I see that a three month physician-supervised weight loss, if that is what you are talking about. the requirement could possibly be coming from your surgeon and not Medicare. But you are so close you can touch it, right?  Before you know it we'll both be happily working the plan and losing our excess baggage!

 

Regarding your sugar levels: they need to be sure you are as healthy as you can be before they put you under.  The healthier you are prior to surgery, the less likely you are to have serious complications during and after. 

 

I feel blessed that so far it has been pretty smooth sailing, but I am just waiting for a huge wave to capsize my boat!  Now I am waiting on a CPAP, but the dr said there is no requirement to repeat the sleep study.(I hope I hope I hope!)  I have not yet seen the surgeon, so I'm biting at the bit a little for that.

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Medicare w United AARP Supplental Insurance Timeline: 

PCP Referral Submitted listing Previous WL attempts and General Seminar:     4/28/2016

General Group Nutrition Seminar:  6/09/2016

Bariatric Program Physical: 06/11/2016

Psych Eval: 6/28/2016

First 1:1 NUT session (required by program, not Medicare): 07/05/2016

Sleep Study: late July 2016

Followup Sleep Study: late July 2016

Second 1:1 Nut Session: 08/02/2016

Cleared for Surgery: 08/03/2016--Medicare requires no pre approval. No waiting to hear back from insurance: if you meet program requirements, you AUTOMATICALLY qualify.

Meeting with Surgeon: 08/04/2016

Sleeve Surgery: 08/19/2016

 

 

 

 

 

 

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I had surgery with Dr Halpin dr Pattersons partner..... personally I picked Halpin because I loved her no bull #/^_% approach, attitude and no false promises. She's very straight forward. Maybe you can see both and pick? I asked her to give me the smallest sleeve possible hehe my one year anniversary was August 26th and I lost 140 pounds from surgery to 1 year anniversary. 

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Opps didn't realize this was an old post.....

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