Wondering about Medicare paying, any advise would be great!

Charlotte B.
on 9/6/06 10:07 am - MO
Congratulations to all of you that have had your day in surgery. I want to make this happen for me and hoping anyone out there can help. What are the procedures to go through to get Medicare to pay for the lapband? And??????? Is it true the facility must be a Center of Excellence? Getting pumped up and looking forward to doing this! Thanks in advance for any help you can give me....Good luck on your weight loss! Charlotte
Jan C.
on 9/6/06 12:38 pm - Cedar Creek, MO
dont know about medicare paying for lapband . but you dont have to do much to get them to pay for RNY. Yes the surgery has to be in a place that is a Center of Excelllennce and there is only on in the state of Missouri and that is Sedalia that has a Doctor that will also take Medicare. Which is Dr. Hornbostel. do you live in Missouri and if so where? welcome to the board and if i can help any other way let me know. Jan
Charlotte B.
on 9/6/06 1:20 pm - MO
Jan, Thanks so much for responding. I know medicare will pay for the lapband, but....how do I get started? Through my regular MD referring or from an MD at a lapband seminar? I am on Humana Gold Plus and they told me that if medicare approves it then my HMO will pay it all. I do live in KC Mo so Sedalia will be the place to go. I am 59 and just been determined as disabled from degenerative disk and joint disease, osteoarthritis and buldging disks. Your profile is much like me so I understand what you have been through and the things you are unable to now do. Thanks for the Dr.'s name too. Will call and find out some info. So glad you had the surgery. What type is RNY? A newbie here. LOL Let me know how you have done in weight loss and exactly where you live. Continued success Jan! Charlotte
Jan C.
on 9/6/06 4:39 pm - Cedar Creek, MO
i live in Cedar creek which is about 80 miles south of Springfield. almost on the Ark line . we live on Bull Shoals lake. RNY is the gastric bypass surgery. I had it done on the 14 of August and have lost 25 pounds so far. not bad for what is considered a light weight. I am 5 foot 3 inches tall and started out at 258 now down to 233. Is your regular doctor wanting you to have this also? But the first thing to do is to go to a seminar of Dr. Hornbostels. At that seminar they give you papers to fill out and when they get all of that stuff in then they call you for a consult with Dr. H. they then get approval from you insurance and then call you for your surgery date. and pre-ops which are usually a week befofe you surgery date. The only thing i had to do other than my pre ops was get a pshy.consult. They do all the other testing on the pre op date. I think you just missed this month seminar. but you can go to Dr. Hornbostels patient forum and look up when they have the next one it is listed on the left hand side under events. Hope all of this helps you some. Jan
Charlotte B.
on 9/7/06 12:04 am - MO
Yes, Jan, your info has helped me. Thanks so much! Boy you are really doing well and such a short time from your surgery. Congratulations! Please feel free to keep in touch and let me know how you progress. Your new found friend, hopefully a light (er) weight soon..LOL Charlotte
Jan C.
on 9/7/06 4:46 am - Cedar Creek, MO
be sure and come back often i do a daily post that everyone seems to post to so feel free to do so too. Would love to know more about you and your journey. Jan
Debbie M.
on 9/7/06 6:37 am - Harrisonville, MO
Welcome to OH, Charlotte! My name is Debbie, I'm 48, live in Harrisonville and I too will be having the Lap Band (Medicare covered)...hopefully! I also suffer from DJD and DDD...have had 2 back surgeries and possibly looking at 2 more after weight loss from Lap Band. Dr Geoffrey Blatt, my microsurgeon is the one that recommended the Lap Band for me and my primary agreed. I got referral letters from both. I have been disabled since 97. I had my one on one with Dr. Hornbostel last week...he is great! With what he told me, it will take about 3 years for me to get where I need to be weight wise. You don't lose as fast with the Lap Band but I'm okay with that because it will give my skin time to shrink back into place....hopefully! He said for my height and structure I should be weighing in at about 140 to 160lbs. If I get under 200lbs, I will be happy! In a way, it angered me to hear him say my weight would be good at 160lbs. Not at him, my primary or Dr. Blatt. It was from neurologists, other Dr's and surgeons that told me YEARS ago that I was to fat for back surgery at 160lbs!!!!! Now, almost 10 years and 130lbs later, half of my back is gone! It makes me wonder how much time and money was wasted on steroid shots and pain blocks (that only helped me get fatter), physical therapies, pain killers, muscle relaxers, MRIs, Discograms, Mylograms, traction, down time, lost careers, the hospital stays and surgeries, not to mention missing both of my parents and my brother's deaths and funerals???....sorry, had to vent a little! Sorry Charlotte, ignore that! I'm sure you have been through your share of the "jumping the hoops" stuff too! I just wish my doctor's BACK THEN would of listened to what I had to say instead of thinking their God! If they would of, I probably wouldn't be going through what I'm going through now. Again, welcome to the sight and best of luck with the insurances and your wls! Deb M.
Charlotte B.
on 9/14/06 11:11 pm - MO
Debbie, thanks for the email. I guess you have seen your days of ups and downs. Let me know how long it takes for you to get scheduled for your surgery after you see Dr. Hornbostel. I am going to go on the 3rd to his seminar and get the paper work. Never worry about venting to me. I think all of us have had to do some of that at some time. Good luck on your surgery! Brighter days are ahead for all of us. Charlotte
Debbie M.
on 9/14/06 11:37 pm - Harrisonville, MO
Thank you Charlotte for understanding...lol, I was venting again when I got your email! Either you have bad timing or I just vent too much!...lol Medicare approving me may take longer than most due to my primary insurance being Coventry and it has to go through them before it goes to Medicare...I believe! As far as Medicare approving you, as long as you are healthy enough to get through it, they'll do it, by the way it sounds. Dr. Hornbostel and his staff are great! I have had no issues, as of yet and I don't see any in the future! Everyone on here seems to be happy with him and I think you will be too! I will let you know whenever I get approved! What am I saying??...EVERYONE on here will know when I get approved!! LOL Stay in touch tho, seriously I do get forgetful at times...so keep an eye on the board! Have a wonderful God Blessed Weekend Charlotte and it's nice meeting you! Deb M.
pattycakes
on 9/9/06 2:58 pm - new franklin, MO
hi everyone, i am new here. i have been on OH for about 3 months. but just now getting on the missouri board. i am from new franklin, missouri. i have been on this mission for about 5yrs. now. but my insurance would not pay for it. well, due to my health, i am not working. and finally after getting a lawyer i was accepted for medicaid. i weigh 360, i am 5'5, highblood pressure, type 2 diabetes, severe vericose veins in my legs, bipolar disorder, manic depressive, severe anxiety, shall i go on,lol? i have my first consult with dr. scott sept. 21. they take medicaid. does anybody know how hard medicaid is to deal with on RNY? patty
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