Question about Medicare

(deactivated member)
on 8/5/09 6:22 am - KY
I just read on the internet that Medicare requires the following before approval of wt. loss surgery - 3 month multi-disciplinary diet, exercise and behavior modification program with neither supervised by the surgeon and psych evaluation ... also instead of the 3 month multi-disc. diet...whatever that means I have NO IDEA....a 6 month weigh in with your doctor on a diet.  This is news to me...I was just told you had to have a BMI over 35.  Anybody know????
jkhawk8
on 8/7/09 3:50 pm - Alexandria, KY
Do you have Original Medicare, or a Medicare Advantage Plan (managed by a private insurance company)?  If a private company is managing it, there may be a difference in the requirements.  I have Anthem Senior Advantage, and while I didn't have to complete a 6-month program first, I did have to prove (with medical documentation) that I was unable to lose weight using non-surgical methods.

But if you can't document previous attempts, you may be required to do a doctor-supervised diet first.  You should be able to contact your insurance company (whether private or the Federal government) for specifics on your coverage.  You should receive an update on your coverage each year, generally in booklet form.  There should be phone numbers in there.  Also, the back of your insurance card should have contact numbers.

Good luck in your research.
Jan


            
(deactivated member)
on 8/13/09 9:40 am - KY
No, just the regular.  I have since found out that as long as I find a COE hospital and have a BMI of 35, I'm approved for surgery.  I have to pay 20% of all doctor and hospital charges...which is okay by me.  To be able to feel good again would be so wonderful.
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