Atl. Medical Center Seminar...

I attended the seminar at Atlanta Medical Center last Saturday June 30th. Other than 2 of the 4 A/C units not working (i.e. it was hot!), I thought the seminar was excellent. It was very informative, well run, organized and the presentation was great. It was attended by a few hundred (my guess). One of the things I noticed was that there were a lot of really ill people (that would include myself) that NEED this surgery...RNY was the main topic. I was also delighted to hear some VERY strong statements regarding what seems to be the fact that RNY in almost all cases cures diabetes type 2. As one who has been ravaged by this curse, it's difficult for me to put into words the emotional uplift that provided for me. Unfortunately, as with most things, I also heard some things that were not very comforting. The prime discomforting information was that there is no such thing as a Medicare pre-approval. Apparently, if you can, you have the surgery and hope that Medicare will approve it, but you will NOT know going in. Of course you have to sign an agreement that you will pay all the expenses if Medicare decides to deny approval. While that would be a wonderful option, it's totally unrealistic for people like myself that barely survive on their SSDI income. Of course a part of the form to fill out prior to surgery is your income. I guess the surgeon and/or his or her team will then determine whether or not to do the surgery based on whether you can pay if Medicare does not. While I have a plethora of co-morbidities (although I have been deemed well enough to have the procedure), I find it incomrehensible that Medicare (or any other provider for that matter) would deny people that are very ill with diabetes type 2 and the co-morbidities that arise with it. If nothing else, it would seem to make an awful lot of economic good sense to pay for the surgery, as if it does indeed cure diabetes (type 2), then an awful lot of money will be saved by Medicare and the other providers in the long run. I have however been in the "system" so to speak, long enough to know that just because something makes eminent sense does not mean the provider will see it that way. I ask that any and all of you out there that have had the surgery done and are on Medicare and or Medeicaid reply (in private via PM if you so choose) and let myself and others know your experiences as to whether you were approved or denied. It has been virtually an impossible task to even find a surgeon that will see me because I'm on Medicare, and now with having to fill out the financial income, it would seem that that will also shorten what is already a VERY short list. Please let me/us know what other co-morbidities you had/have as well. I think my only salvation is that I am so ill and have so many co-morbidities that I will be approved...then again...who knows. Thanks for listening, (and hopefully responding with your own experience/story) and I hope for better health and life for us all. Aspire to inspire before you expire...

Things must have changed since Duncan's last seminar in May.  I attended with some new friends and they did not mantion any of the stuff about medicare not paying.  I have known many many medicare patients using Duncan's office without any problems.  Muct be some new problem with medicare.   My surgery was just 3 months ago and I have medicaid.  I had no problems with the iinsurance.    Have you started to get your approvals / clearances yet?  The faster you get them in the better your chances especially if it is because maybe medicare is running out of money (just a guess).   Will we see you at one of the Atl Med Cntr support group meetings this month?  There will be one on Tuesday the 10 @ noon, Thursday the 12th @ 6pm, and Saturday  the 21st @ 9am.   I will be going to the one on Thursday evening.  Hope to meet you there.   Keep thinking good thoughts and keep us posted on your progress.

Hi: Thanks for posting. I guess I didn't make it clear. It was not said Medicare would not pay, just that you would not know whether or not they were going to pay prior to the surgery. Dr, Duncan was not there and neither was Dr. Hobson. I'm working on clearances/approvals now.  I live quite far away, so no I will not be able to attend the meeting, as much as I would like to. Thanks again, and I will keep updating. More posts please people of your experiences with Medi/Medi and WLS.

Hi, I have medicare for disability, and I called medicare, myself..IF you have a BMI of 40. or higher they automatically pay..Also if you have a BMI of 35 or higher with 2 co morbidities, they pay, or 100 pounds to lose... I have my date at Dr. Duncan's for surgery for 08/13/07..I will have to sign, but i am confident after speaking with medicare that they will pay..I have a 40 Bmi , plus lots of Co  morbidities. If you meet either of the above criteri with medicare they pay..I wouldn't worry... You do have lots of consults to get done, and if approved a endo.. Hope this helps.. Trishalla Peace

Trishalla: Thanks for posting...I do have all of the things (sadly) you said would sail me through Medicare's requirements, so I feel a lot better about it now. I'm happy to hear that you have a set date for your WLS, and I will keep you in my thoughts and prayers for a successful, safe surgery. Oh, and yes, your post did help a LOT! Thanks...

Your welcome..Glad to help.. Peace Trisha

I am sorry.  I did understand you but i didn't state my info correctly.  what I was trying to say was that they never had to wonder if Medicare was going to pay before.  It was a given, if you qualify they would approve and then they would indeed pay for the procedure. I understand about not coming to support group meetings because of distance.  I have to drive for just about an hour to get there myself.  You do have to attend at least One support group meeting to qualify for the surgery.  It is one of the requirements.  It is about the same distance from canton or Henry county to get to the meetings.  Good luck

Hi Pat, Where do you go for the support meetings?IIIIIIIIIIam going to try to make it on Thursday evenng, 6pm, but just don't know where to go.. Trisha

Hey Trishalla, The support group meetings are in the same building as the seminar, the wellness center.  You take the elevator up to floor 2R.  Let me know if you are indead coming and I will be sure to look out for you and say hi.  I think I may even owe you a supportive hug.  LOL.  Talk with you soon.  Take care.

I am indeed going to domy best to be there..So I will look forward to seeing you there.. Trisha Peace