My firt post, am I coverd? I have medicaid & Medicare.

Hello, My name is Joe. I'm a 32 year old father of 3. I have been overweight all my life and as of now  I weigh about 500 lbs. I am how ever very strong with lots of muscle & lots of energy. I can walk 3-5 miles on a tread mill at my local gym, but the weight is still here and doesn't want to go away. Also it very hard on my back and joints. I have degenerative disk disease and degenerative joint disorder. People say I don't look like I weigh as much as I do. But yes the scale at my local hospital is correct. My Dr. says I'm a perfect candidate for gastric bypass surgery. What I need to know is will medicaid or medicare cover it? I was told by a friend that one of them would but I need 6 months of Dr. supervised dieting and a hospital that is a "center of excellence" . I know of two in my state both up near Indy, St.Vincent & St. Francis, and I called St. Francis yesterday. They are sending me some information. Any one on this board have any information that may help me? Please pass it along to me. Thanks... Joe...Washington Indiana...

Welcome to the IN message board!  I know that one of your insurances covers WLS--I am thinking Medicare does, but you need to call them directly to find out exactly what the requirements are and what the coverage is.  I am having my surgery at St. Vincent's, which is also a center of excellence, but I am sure St. Francis' is great too if they are also centers of excellence.  You might even want to visit both to decide which you want!  The six month of supervised diet are almost always required--just make sure your doctor is documenting what you are doing, and what the orders for the following month are--for example my doctor writes "Patient is continuing to exercise 4-5 times per week as able to tolerate in relation to joint and back pain.  Continues to follow 1800-2000 calorie/day diet.  Etc..." and then she writes Plan: Continue to exercise... Continue diet of ...

If you have any questions or frustrations--this is a great place to find answers!!

Thank you! I ran into a old friend in town today that is about to have the sugery at St. Vincents, She has the same insurance as me, so she is going to be very helpful on my quest. I will call my insurance tomorrow and ask about what all I need also. I have had the documented 6 months diet in the last year or so but I wonder if I need to have it more current..thanks again...Im learning fast..Joe

Hi Joe and welcome to OH Indiana board.  You will find a lot of great info here.  Your first step is to call both medicaid & medicare and see what they cover and what their requirements are. Then go from there.  Good luck! Jenny