Does Medicare cover WLS

wilma J.
on 12/21/04 2:52 pm - billings, MT
Does Medicare cover WLS if found to be medically needed and doctor recommended?
Linn D.
on 12/23/04 8:31 am - Missoula, MT
Wilma, I have a friend in Bozeman whose mom is going that route with medicare. She does need to have some other co-morbid condition in order to be approved so she is having a sleep test done. She really doesn't have any other major medical problems besides her knees and mobility issues. However, I think if those things were documented she'd have a good shot of getting approval even without sleep apnea, but each surgeon approaches things differently. I'm a federal employee and I'm pretty sure the reason I got approved was because of my knee and back problems since my BMI was barely above 40. Talk with your medicare coordinator (or someone who knows what the rules are - customer service rep, etc.) and see what the requirements are that need to be met. They really are a wealth of information and you don't really have to give them any in return. That's how I got started with my process. You will have to be sure your regular physician gives you a referral, though. Good luck! Linn LapRNY 02/17/04
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