Medicare

Hey has anyone had any experience with Medicare to see if they approve the surgery? Mattie, Topeka, KS

yes. They will approve if you meet guidleines having to do with co-morbidities... LivLite in Junction City is the group who is going to do my r n y and they can tell you up front if you would qualify under medicare guidelines. let me know what you found out! I care, and am looking for pen-pals to share this journey with..... have not had initial consult yet, as the ONLY thing not yet in my file is the letter from my pcp! ;-{

I am curious if you have spoken with LivLite. I thought they told me that Medicare wont reimburse them. I called Medicare and they told me they would cover the surgery as long as I went to a Medicare approved facility and it was medically necessary but they dont preapprove anything. Then I called Via Christi's program and Dr Porter and was told by their program that their surgeons wont take Medicare. I am pretty frustrated now, every insurance I have had didnt cover the suregery for the last 3 years and now I have an insurance that will cover the surgery and I cant find a surgeon that will take it.

Hi Carrie! Have you spoken with the group in Junction city at THEIR '800' number? the MAIN number for LivLIte is in California, and you will not get info that applies to Kansas.... Junction City # is 1-877-558-5483, you will talk with Pam or Pattie. Medicare has a list of co-morbidities that you must have medically documented in order to qualify --- (and yes, they NEVER admit to ANYTHING as being pre-approved if you ask Medicare directly!!!!) The list includes: sleep apnea, type II diabetes, BMI > 40 or 45 (?), Polycystic ovary syndrome, arthritis in a weight-bearing joint (hip, knee, etc.) and some others, i don't have the paper work in front of me right now. AND 6 months in a physician-supervised weight reduction program within the last two years. No matter what your co-morbidities are, either you have already been through a program or you start now and they talk to you again in 6 months...... a lot of hoops to jump thru, i know..... I hope this info is helpful. hopefully i will have my initial consult this week. I am going thru some little moments of being "spazzed-out" about the surgery and life after (i have a medical background and really, too much info can be harmful!) but every time i struggle to stand up from a sitting position, or worry that i won't fit into a chair to begin with, i do a 'reality check' and KNOW that this surgery is the right choice for me. let me know what you find out! ;-} anita

Anita, I just wanted to thank you for the info - I called LIVLIte and spoke with Pattie and they do accept Medicare. She is sending me the packet so I can fill out the paperwork and sign the release forms - I might have to do the 6 month supervised weight lose program since it hasnt been within 2 yrs but they are going to review my chart and I am going to call my PCP and see if she can see about it I mean we have been working together on this for the last 3 yrs but I am not sure if it is actually documented as required - anyways I will do whatever it takes I am having this surgery!!! I just cant wait !!! Carie Betkel Cheney, KS

YEA!!! I'm blessed that you were able to finally get hooked up with the right folks! Fighting the insurance game can be madenning... it sounds like you've got the ball rolling now! I live in Wichita, so we're practically neighbors... let's DO keep in touch! I still haven't had my consult yet, probably next week....... Take care! Anita Trainer Wichita, KS