Medicare Approval.

There are articles online that show their policies as was told us. From what I read, they are positive about it, and feel it helps. But they only allow a few hospitals, and you can look up which are allowed, by state, to see which one is allowed in your state.

When I was starting this whole journey, I found a doctor near my house but after researching I found out that the hospital that he is asscoiated with is not approved. Imageine my shock to discover that one of the biggest hospitals in Oklahoma is not medicare approved. There are only TWO hospitals here that are ones is about 35 miles from me in Norman OK. and the other is in Tulsa a good 2 and a half drive. Needless to say which doctor I chosed

I was surprised too, but then I realized for me, that if I have to drive, It is not going to destroy me, as this is for a surgery--If I get fills for the band, it can be elsewhere. I was amazed they are so narrow, but as the choice is so good, I cannot complain. Jeannie

Driving does not bother me, it just seems so strange that a major hospital that does organ transplants is not approved.. That kinda bothers me. What I thought was funny is after I found that out the surgeon at that hospital does not take patients over 400 llbs. So either way it would not have worked for me. Found out today from my PCP that the surgeon that I am using has taught the surgeons in the area the procedure. And he has had it done himself. Plus her Mother had the band done by him last year. That settled it for me.

Well, California has wonderful hospitals, and only two are favored.  Thing is the learning curve is where they lose patients--I think.  when there is a lot of volume we are better off, I think. I was amazed taht they only had a san diego hospital, AND alta bates in berkeley, which puzzled me, but I am okay about this concentration of work--as I can be sure the program has been thoroughly looked over and standardized, and starting out with them, I feel good already. It is such a hard decision, I guess there is no way we can do all the stages of decision making in a few minutes, and it is good to take it slowly and be comfortable with each step. Good luck fo ryou. And, I think you are wise to find a specialized location. Jeannie

 When I started this whole adventure, I researched hospitals, docs their rates of recovery and the big evil death rate. DR. Keith has had the surgery himself, has taught the procedure, and has a great rep for doing  his work. Plus I then went toured the hospital and it settled it for me. They are trained for large people and have all the equipment to handle large. So that settled it. I would think Calif...(BTW my home state )would have more approved hospitals. you can only please one person at a time, the first one is yourself pattye

You have a handle on things, seems to me. I have a question--why are not more peole doing the lap band, as there is less risk? jeannie

Thank you so much for that! I think that most people prefer the RNY because of the weight loss is greater. People on the band tend to be able to eat just about everything they want, and eat the sugar that on the RNY you can't. I have read in some cases its only for those who's BMIs are 35 and lower. When I said that on another post I got blasted by a woman who BMI was 65 at the time of her surgery. Like I told her if you read enough you will read just about everything there is on WLS. I just got an email from a woman who after having WLS is now hyperglycemic. Her body preoduces way to much insulin and has to have glucose tablets and peanut butter at her desk.  pattye sue.....

Medicare covered their portion of my rny without a problem.The problem is finding a surgeon who will take medicare. Alot of surgeons are reluctant because medicare does not pre approve the surgery. You just have to find a surgeon who will accept it,get the surgery done and then submit all the info after fact...if they find it is medically necessary they will cover there 80% but if they find it wasn't medically necessary (not enough) comorbs etc..... then they won't pay their portion and then surgeons don't get paid....It is unfortunate that it is hard to find a surgeon who will accept it but alot don't for this reason.  I did have a lot of comorbs though so I was pretty confident that medicare would find it medically necessary after the fact and i would not get stuck with the bill. I also have fibromyalgia which was not considerd at all by medicare to be a co morb.  

well i also have federal blue shield, and if they don't cover at all, the blue shield kicks in. I wonder if osteoarthritis is a comorbidity. I also have apnea. And, medicare favors certain hospitals. Surely the doctors working at those hospitals would know what to do about the situation? Thanks.