medicare advantage plan goes by medicare rules...im approved

i asked earlier if they were supposed to go my medicare rules because i was worried about a supervised diet... it didn't matter the advantage plan went by they medicare rules and i found out i was approved last friday and got a letter saturday from my ins co.

I have medicare. Can u tell me what u did first with ur insurance? Did u write them a request letter or what? Thanks Cathy   from Ky

Medicare does not pre-authorize any medical services that are considered "medically necessary".  For WLS, "medical necessity" is defined as follows: BMI of 40 WITHOUT any co-morbidities BMI of 35 WITH at least one serious co-morbidity (such as hypertension (high blood pressure), heart disease, diabetes (Type 2), and sleep apnea)

I have had several surgeries that were covered by Medicare.  None of them required any pre-authorization from Medicare.  Therefore, I was in the "express lane" each time, meaning that all my surgeries were scheduled much sooner than if others had to go through all those hurdles with their insurance companies.

To answer your own question, I am sure that Medicare works the same way as far as WLS goes.  I didn't have to write a letter to Medicare either.

thanks vicki. i hope i dont have to wait 4-6 months for surgery.