Medicare Stinks!!

If anyone has Medicare as their primary insurance you'd better call your doctor to see if they will be doing the operation. Medicare will not pay if the hospital does not do at least 125 surgeries a year. The only one that does is in Bangor. I am all set for it in Portsmouth hospital and now have to self pay. Good luck.

Hi - Maine Medical in Portland, Maine is applicable under Medicare rules. It's a lot closer than Bangor. Give it a try - I just had mine done there 1/23 and I have Medicare. Dot

You were lucky to have it done in January. this is happening as of Feb.21,2006. that hospital is not approved either, just Bangor.

Dear Sandy, When I read your letter, I had to shudder at the phrase "self pay" and knew I had to get registered on here and reply to you. My hubby had surgery on December 1, 2005; we were told his surgery would be 5 hours tops and would cost roughly $25,000. His surgery lasted 10 hours and the final bill was $106,000. He has ended up with severe ulnar nerve damage in both arms from his elbows to the ends ofhis fingers and has to have physical therapy twice a week and travel over 150 miles to see a neurologist and orthopedic surgeon on a regular basis. We are possibly looking at more surgery to correct this nerve damage that resulted from his arms being in one position too long during his surgery. Please think very carefully about having any surgery like this on a "self pay" basis. It can become a nightmare that won't end in some cases, such as my husband's. Anthem paid for all his initial surgery but $650 but there are a lot more expenses now. He only had 120 lbs. to lose and has already lost 80 lbs. in three months. I'm sure he would have the surgery again but would check out the surgeons and hospitals much more carefully. Pam

Sandy, I don't think what you're saying is applicable only to Medicare....the field of bariatrics is changing rapidly - and in many studies that have been done, it's been determined that many, if not MOST of the post operative complications are in persons who had their surgeries performed at a facility not well equipped to handle bariatric patients or that the person's surgeon hadn't done very many of the surgeries previously. To correct this situation, they've started developing places called "Centers of Excellence" and insurance companies, Medicare, anyone who foots the bills for surgery of this type has determined the minimum number of weight loss surgeries performed per year to qualify has to be at least 125 or more. So don't blame Medicare - they're not saying you can't have surgery....only that it must be performed at a location they consider optimum for your recovery and well being. If I were you, I'd go to Bangor, if need be....it would be a LOT less expensive than self paying your surgery.......MJ

I have MaineCare as my only insurance and they paid for everything with my surgery on March 13 at Maine Medical in Portland, ME. The hospital was great also; the nurses on the medsurg floor were great and I could not have asked for anything better. Dr. Roy Cobean at Maine Bariatric Center did my surgery and the office was more than helpful from day one.