right weigh says not eligable!!! frusterated

hi well i got news from dr. gellar and suburban that they dont think i am eligable under my medicare. my bmi is 41.6 i have been 100 pounds iver wieght for well over 5 yrs. have documented weight lose failure. have all the test and studies done. i have very mild sleep apnea that the sleep dr. wants to treat with weight lose. i am not on a cpap . o have fibromyalgia and the weight just makes all of its symptoms even worse. i am very upset and furstrated. i think i just give up!!!!!!!!!!!!!!! i mean they must want me to be darn near dead before medicare will pay. i see why people just give up!!!! maybe iam suppossed to just stay obese and suffer for the rest of my life.......

Medicare WILL pay if your surgeon says it is medically necessary. no questions asked. I started out with Dr. Gellar but it didn't take me long to switch to another doc. It was when he first started with Dr. Shina and I don't think he quite knew what to do with me. (My situation was complicated). Is he not willing to write you a letter of medical necessity? If not, perhaps you need to get all your records and change to another surgeon. Good luck

try doc Rodrugiz in Louisville, 5025838303 his office knows how to write it so the ins will pay..

Chea: First of all ~~ DON'T GIVE UP! I don't know Dr. Gellar but I do know Dr. Shina. My story is long and involved; however, I am now seeing Dr. Rodriguez who is with University Physician Services. His office #502-583-8303. You will have to start all over with a Seminar, but if there is a way his office will find it. I have insurance with my husband's company but the company had an exclusion for Morbid Obesity Surgery. The denial initially happened when I went to see Dr. Shina in April. I previously had surgery in 1997 and my stomach (old and new) grew back together at some point. I had only lost 80 pounds in 1998 and then I reached some sort of stopping point. I had a lot of emotional problems at the time and I could not get out to exercise so when Dr. Shina indicated I would not follow his directions I opted not to see him anymore. In March of this year I found out about the stomachs rejoining and I went to see Shina first because I found out that there is a Revision Surgery (actually repeat of sorts). Anyway Shina blamed it all on me. Told me that I had caused the situation and although it was my fault he would do surgery. I was denied by the insurance company and IT WAS THE BEST THING THAT COULD HAVE HAPPENED. I am a strong believer in prayer and God led me to Dr. Rodriguez through a beautiful woman at Meijer's. Rodriguez's office filed an appeal with all the correct information and I was approved last week. It has been a long summer and although I do not have my date yet ~~ I am going to have surgery. After I was denied by the insurance company (I also have Medicare Part B) I contacted Medicare and I was told that there is a one time exception provided that I met the criteria. Dr. Rodriguez' staff KNOWS THOSE CRITERIA. They can help. Best Wishes. Take Care.