Medicare Questions

Greetings all. I have spent all of my time researching the surgery requirements for Medicaid and now I have been denied. I am on Social Security Disability, but for some reason Indiana doesn't think I'm disabled. I'm baffled at this whole thing. Now I have to wait for my Medicare to kick into effect in December. Anyway, can anyone please help me out with any info related to Bariatric surgery and Medicare? What needs to be done, any requirements, etc... Thanks!

I would think once your Medicare kicks in, you start over. You might want to call Medicare's toll-free number and have them send you their pre-surgery approval requirements...that way if there is a requirement for doctor supervised diet, you can get started on it now while you are waiting for the Medicare to kick in. Good luck on your journey.

i know nothing of medicaid. just wanna say, i hope it works out i would use this time to be going for monthly weigh ins and use this time to find out what they require and so in dec your all ready to go...keep us posted

Have you filed an appeal with Medicaid yet? Because, if not then that should be the next step. I don't understand how the state can't agree that your disabled when the Federal Government says you are, just doesn't make much sense does it. As far as Medicare - because I followed Medicaid's guidelines for approval and so Medicare didn't deny me. I hope things work out better for you soon.

Unfortunately I have exhausted all my appeals with Medicaid. Stange how Indiana works.

I know that Medicare revises their stand on gastric bypass every year. LAST year (2005) there was no pre-approval necessary....Medicare states they will cover any procedure that is proven medically necessary. Of course, the majority of people on Medicare aren't eligible for the surgery (many surgeons have a cut off age around 62-65). I'm disabled but not on Medicaid, just Medicare. My surgeon had to fight for 9 months to get paid after the procedure, though. Medicare didn't question the hospital charges or anything other than the actual surgeon & asst surgeron's charges. Also, be very careful when you do see doctor's for a consultation. One tried to have me sign that I would pay him $6000 no matter what Medicare paid or didn't pay. I believe that is illegal, and he's a very respected doctor in the Carmel area. If I can help in any way, feel free to email or message me!

Keep your head up hun, I am not sure on Medicare's procedures. But if you need any moral support, I am here for you. -Amy A

Thanks Amy... and I voted for your essay this morning. You are in a BIG lead. No doubt you'll win the contest. Myra, if Medicare won't require preapproval when I try for the surgery, I think they will probably approve it after the fact. With my co-mobids, I think I'm a great candidate.