I have Medicare parts A and B - and AP/IPA

HI! Does anybody know which doctors will take Medicare and AP/IPA? That's all I have besides my primary care and cardiac specialist's recommendations. Now I'm scared it won't be enough. Please help! Sheryl

Hi! I have medicare as my primary and ahcccs(apipa) as my secondary although my secondary used to be cigna ahcccs... I had surgery with Dr. Blackstone June 9,2003 and have not had to pay one cent. Although she no longer accepts medicare .... Medicare does not preapprove gastric bypass surgery. You just have to find a surgeon who accepts medicare.After you have the surgery, all of your medical info then gets submitted to medicare and if it is found to be medically necessary they will pay there portion of the bill...the rest gets submitted to your secondary insurance. If your secondary is a state funded insurance they have to follow medicares lead and pay the remainder. Do not let anyone tell you that you still have to get preapproval from your secondary prior to surgery, as this is not true. My secondary insurance repeatedly told me for a year that I needed preapproval through them first even though I did not need preapproval from medicare. Thank God I finally spoke to a supervisor and found out that was not true. My profile talks about this in depth.

hI Jennifer! Ok -- let me get this straight -- Medicare didn't require an approval and AP/IPA as my secondary insurance doesn't either? Does that mean I mean automatically approved?? This is getting really exciting! Thanks for your response before. Sheryl

Medicare will not approve or deny payment before you have surgery....all of your medical information gets submitted to them after you have surgery.If they decide it was medically necessary then they will pay their portion or they could find that it wasn't medically necessary and not pay. It's sort of a risk. You do have to make sure that it's medically necessary and have some comorbitities due to your weight and have the medical documentation to prove that it is. Ordinarily,when you are dealing with more than one insurance you would have to get preapproval from the secondary as well as the primary.BUT since both of your insurances are federal and state insurances this is not the case.If medicare finds that it was medically necessary then by law apipa has to follow their lead and pay their portion but if medicare denies your claim then apipa wouldn't have to pay either.Although I have yet to find anybody that was denied by medicare and then gotten stuck with the bill.

Dr. Terry Simpson.........an incredible caring doctor that does not have a six month plus waiting list. He does do the Medicare.

Dr. Simpson is a great surgeon however he charges something like $1,000 for nutritional classes that he requires before surgery.This is completely out of pocket and no insurance will cover it .Most other surgeons offer preop teaching for free. Someone on medicare and a state funded insurance is not likely to be able to afford the fee that he charges. I know I couldn't. Also Dr. Simpson prefers to do the DS procedure and I didn't want the DS I wanted the RNY.

Thanks Jennifer! I would have gone with Simpson because of the short waiting list but I'll stick with Zahn now. I can't afford the $1000 either. That's why I have the Medicare and AP/IPA. I'm poor but deserving -- honest!!!!!!!! Yes I want the RNY too. Thanks again -- Sheryl

I have both parts of Medicare also and I also have MSSP (Maricopa Senior Select Plan) which is a state funded program, I am now waiting for them to finish reviewing my records. My surgeon is Dr. Simon who works with Dr. Newhoff, they do nothing but WLS (both open and Lap). Thank you for posting this question, I have learned from the replys. Jan