Denied due to Bipolar

I did everything to get ready for the surgery and got to the psychilogical. I was denied by Medicare because I'm bipolar. The Dr said 100% of patients are denied if bipolar by Medicare or Medicaid. This sucks! I have almost all comorbidities, Im easily 100 pounds overweight and I desperately needed the surgery. Oh well. Not sure what to do now!

Good luck everyone! Hope everyone else gets approved!

That's not true. Thousands upon thousands of bipolar people have had WLS, many of them covered by Medicare. In fact, Medicare doesn't pre-approve anything. I suggest 1) calling Medicare and find out EXACTLY what qualifies one for WLS coverage, and 2) seeing a different surgeon, one who has a staff that will go to bat for you.

I agree with your other poster. That surgeon doesnt someone who is bipolar for a patient. Time to look for a new surgeon who is not biased. Your preop stuff will Cary over to the new doctor. Be sure you ask NOW for a copy of all your records/ preop test results.

I worked with may clients in the Social Services field that were physically or mentally disabled. They had Medicaid or Medicare. Many had WLS approved despite their diagnosis.

I agree with the other posters. Check into this further, and don't be afraid to be a sqeeky wheel!

Good luck!

I just want to agree with the previous poster.  Call medicaid and get the scoop from them.  That doctor sounds like a real asshat.  There are plenty of bi-polar WLS patients on this site -- I hope you will seek another doctor who won't discriminate against you!

Bipolar surgery patient here! I have private insurance (BCBS) and had no trouble with the psych clearance; my regular psychiatrist just wrote a letter saying I'm stable on my meds and a good candidate for surgery. Hopefully you can get them to take a second look at your case if you get more information.

Hummm you all make an interesting point!!!! I failed the psychilogical for the surgery. He said I was bipolar and to anxious and needed more help (counseling or meds). I am under control with my bipolar BUT I dont want to be to under control because thats how I got my disability in the first place. I have medicare and medicaid now with my disability. I dont want to mess up my disability, but I also despirately need the surgery. I am in counseling and seeing a psychiatrist on a regular basis. I think I will file an appeal and just see where it goes! And as for a new Doctor....I will be looking!

THANK YOU!

Bottom line---unless you can pass the psych exam, NO ONE will do surgery on you, and even if they did, Medicare wouldn't pay for it. You MUST get your psych issues under control in order to have WLS.

But, you won't lose your disability just because your permanent, disabling condition (being bipolar) is under control. Don't file an appeal at this point---I don't really think there's anything TO appeal yet. Do the counseling, get the psych clearance, have WLS. Medicare doesn't pre-approve---you get the surgery, the surgeon submits, and as long as you meet ALL the necessary qualifications, Medicare PAYS.

I just made a call to medicare the other day. They dont require anything pre-op. Its all up to the surgeon and what they want. I suffer from depression/ anxiety and Im on meds. My psychiatrist will approve me for the surgery. And Im sure the psychological will go good. Seek a new surgeon. Good luck!!

It may have just been the Doctor denying me! I called Dr Patel's office in San Antonio and they stated it's on an individual basis not 100% denial by Medicare. Medicare stated nothing had been submitted yet! So I made an appt with Dr Patel.....so here we go. Wish me luck!