Medicare shuffle

Anyone doing this dance? Or thru w/it? I've got just about everything Medicare "requires" to OK surgery (+130#, CHF, COPD. Type II diabetes, apnea, lousy joints and no quality of life!) but have discovered a call to Medicare gets no info: "We don't pre-approve". Surely would like perspective from any 'vets' out there! Also - I'm in Houma, local docs won't take medicare, West Jeff is closest and hung up for 18 mos for new Medicare requirements, which I'm assuming are delayed thanx to our girlfriend Katrina. Considering Houston, since I have a dotter-in-law and grandson there and shouldn't have to wait FOREVER! Any thot's? I've considered this long and hard - I'm an 'old broad' who used to be young and good looking and, when my doc said "go for it! Whatever'll make u happy", I'm smart enuf to no it won't guarantee happiness..I'm looking for some quality of life, knowing lots of my 'mizries' will go away w/loss. Being able to do some of the things I enjoy again would probably make me happy! Anybody have info on ratio of excess skin w/lapband (which I prefer) vs bypass? Thanx for any help u may have! Elaine

Hi Elaine Excess skin issues are often dependent on age, genetics, race and how much weight is lost. My top weight was 350 and I had several pregnancy/pregnancies losses. My excess skin issues would be the same if I had gastric bypass surgery. I'm losing very slow (compared to most) and stomach and arms are hideous The most extreme hanging skin cases I've seen are from folks weighing 300-400-500 to start or those who get down to the low 100s and below. Hope to see you on the lap band board and don't forget about the Covington and Baton Rouges areas when you are scoping out the talent. Onward! Frances

I am not doing the shuffle as yet, however I expect to in about 6-9 months. You have to use a doctor associated with a Center of Excellence. There are only three in the state of Louisiana. One in Lafayette, and 2 in Shreveport. Please pass along any information you obtain in working with the Medicare process.

Hi Elaine: Centers of Excellence are hospitals that have been certified by Medicare. I am under the impression that the hospital in Covington is trying to become certified to do Medicare surgeries. I am hoping that by the time I can have my surgery that the Vista Center in Baton Rouge will have become a Center of Excellence. If not, I plan to go to McComb, Miss. That will be closer to home for me. I need to contact the doctor's office and/or Medicare and find out just exactly what they need to make a determination of eligibility for this surgery. I will be 65 in December but won't qualify for Medicare for 6 months after that since I won't have my 40 quarters until then. My insurance now is Humana thru the state and it has a total exclusion with regards to coverage for any type of weight control. Soooooo I wait.

After reading thru the replys, i think it would be helpful to say that center of excellence is required by medicare and they do not precertify, but your surgeon, coordinator or hospital will know whether you qualify. I had my surgery at Lafayette, la. Dr. Gary Stevens at the Southwest medical center. It was covered by Medicare and i was very pleased with everything. Hope this helps Thelma

I am from Houma too, I was all prepared to have my surgery at Oschner when the change happened. I don't know if I can list Hospitals or doctors here, but if interested email me before monday, I am having my surgery tues, I can give you their Name address and phone number. Or I will just try to email them to you if I can. abby

Toogie and anyone else. Dr. Ordoyne is getting surgeries done through medicare. I have no clue how it is happening, but they are able to. It may be because he is a very respected surgeon in every aspect.