Medicare and no comorbidities.

Mellylove89
on 1/18/16 12:38 pm

Docotor said Medicare will deny me for surgery because no comorbidities. Nothing he can do for me, besides me paying out of pocket. Anyone else had troubles with Medicare? Should I drop Medicare and get a different insurance? Please help....

Sparklekitty, Science-Loving Derby Hag
on 1/18/16 12:51 pm
RNY on 08/05/19

Call the phone number on your insurance card and double-check on your specific situation; most people's setups vary quite a bit and it's important to find out the exact coverage (or not).

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

Mellylove89
on 1/18/16 12:57 pm

I called the number on the back and they gave me the general information and did mention I had to have a BMI over 35 (mines is 44) and one co morbidity( I don't have any) I mentioned my asthma and the terrible rashes I get and Medicare told me she is not sure if that is covered and to have the provider call the provider line to find out if that would eligible. My doctor office said no its not, didn't even attempt to call. I'm so frustrated with this, I cant afford this without insurance.

(deactivated member)
on 1/18/16 6:47 pm

If you have asthma, it's highly likely you have some degree of sleep apnea. Ask your primary care physician to order a sleep study for you. Sleep apnea is a comorbidity. I'm assuming that your blood pressure, blood glucose, cholesterol is all in the healthy range, right? Those are all comorbidities when out of whack.

I would also suggest you find a surgeon who happily works with the medicare system. A lot don't want to, and it sounds as if your guy may be one of those.  

cappy11448
on 1/19/16 7:48 am

My understanding is that if you have a BMI over 40, you don't need a comorbidity.  Do call medicare and find out. 

best of luck,

Carol

    

Surgery May 1, 2013. Starting Weight 385,  Surgery Weight 333,  Current Weight 160.  At GOAL!

Weight loss Pre-op 1-20 2-17 3-15 Post-op 1-20 2-18 3-15 4-14 5-16 6-11 7-12  8-8

                  9-11 10-7 11-7 12-7 13-8 14-6 15-3 16-7 17-3  18-3

     

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