Medicare

I presently have Medicare with Medigap. I have had uncontrollable diabetes for a long time. Do all bariatric surgeons require a BMI of 35 for two years?

The short answer---no. Do you know if your insurance requires this? Because this sounds more like an insurance requirement than a surgeon requirement.

The clinics I have consulted have varied answers concerning Medicare. The first on told me 5 years the latest on told me 2 years and I cannot find any such requirement in the medicare requirements.

Requirements vary a lot between doctors and insurance companies, so you'll need to get answers from the specific doctor you're looking into, as well as your specific Medicare plan.

My insurance, for example, required a diagnosis of morbid obesity (BMI 40+ or 35+ with comorbidity) for 5 years, documentation required for each year. Others only consider current weight.

Thanks for the info. Has anyone been excepted for current weight? I've been obese for years but this seems to be the last resort for my diabetes afraid I'm about to run into some major medical issues if I have to wait.

I'm having RNY surgery next month. I'm on Medicare and have a plan F supplement. As long as you have a comorbidity you are automatically approved for WLS. Medicare requires 3 mos of Supervised Weight Loss classes prior to your surgery.

Thanks so much. Would hate to know I could not go below 35 BMI for years to come.

I also have a plan F. Do you have comorbidities? Just worried about having maintained the 35 BMI. I have been between 32-35. Thank you.