Medicare w/comorbid

Hi Cheshirecatz,

There wasn't any text to the post you made about Medicare w/co-morbidity.  Please rewrite your post if it didn't save it.

Cathy

Medicare doesn't pre-approve---if you meet their requirements, you have surgery, your surgeon submits for payment, they pay.

Their requirements are that you have a BMI greater than 40 if you have no co-morbs, or greater than 35 with two or more co-morbs. They cover the RNY/gastric bypass and the DS/duodenal switch, and *sometimes* the VSG/Sleeve. The *sometimes* thing seems to depend on who administers your Medicare coverage. Sucks, I know.

Lovely.     However, I  did find some info that said 35 and 1 co-morbid with more than one failed program......wonder if they would accept every edition of Weigh****cher's literature for the past 20 years, the Thrive workbook, and half a dozen other "info-mercial" programs?........seriously, how do you "document" participation in programs like that?!  It's very discouraging to say the least......and depressing.

Weigh****chers stamps my booklet every week.

And now monthly, since I am at Lifetime.

I have years of WW registration books.

If you dont have those, then get started documenting.  You can usually go see your PCP for a weigh in every month, discuss nutrition with them, and keep it up for 6 consecutive months.

Actually, all I had was a doctor's recommendation for WLS and a very obvious comorbid of being a type 2 insulin pump dependent diabetic. My pre-op BMI was 35.2, I barely qualified but they paid the entire amount (I was on a Medicare Advantage plan)

Actually, all I had was a doctor's recommendation for WLS and a very obvious comorbid of being a type 2 insulin pump dependent diabetic. My pre-op BMI was 35.2, I barely qualified but they paid the entire amount (I was on a Medicare Advantage plan)