Medicare Requirements?

karonsexton
on 3/31/10 4:39 am - McAlester, OK
I just had RNY 3 weeks ago, and my sister who is in desperate need of it is now wanting to have it done.  Can any of you enlighten me on the requirements of medicare before they will approve the surgery?  Thank you all so much!
            
Jane W.
on 3/31/10 4:57 am - Southaven, MS
I "heard" it took about 18 months of "stuff".  Have her call the person who does the insurance at your doctors office, they will know exactly.  Good luck.  Hugs, Jane
5'6"    
karonsexton
on 3/31/10 6:07 am - McAlester, OK
WOW that's a long time.  I'm glad I just had a month from my first visit to my surgery!
            
Sudsie
on 4/1/10 1:59 pm - Miami, OK
It didn't take me 18 months to get everything done.  just a couple of months.  she will need 6 months of dr. suppervised diet, I have been a menber of TOPS for several years and they accepted that. There are other dr approved diets that are accepted also. start checking them out. it may be listed on the surgeons website.  The Dr's. office and hospital will have to be a center of execellance. if she has it done at a hospital or by a dr that does not have that then she will have to pay for it.
she will then have to have all the regular pre-op tests done. and know that medicare will not pre approve this surgery so she will have to sign a release that if they don't pay she will. I had no problems with it. they paid everything for me.
Hope this helps some.
Highest Weight: 506.75,   Weight at Consult: 438.50

  
Debbie A.
on 4/4/10 3:35 am
 It will depend on a lot of things, her co-morbidities, how well her primary doctor documents her existing condition,  how aggressive the WL surgeon is in pursuing Medicare, how responsive the govenment case worker is...etc etc.  

I've heard 6 months to a year....but she will need to be aggressive in fighting for the surgery. 

Good luck,

Everything happens for a reason.
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