Medicare Policy Question...HELP!

Because I have scoliosis I am on Medicare.. I am going through them for my surgery. I have been approved for surgery on 10/23.
My BMI at my consult was 40.  I was told I will be weighed again at my pre-ops and if I drop below a 40 my surgery will be cancelled. Is this correct?? I assumed the weight at my consult was the weight I was approved with and that should stand, regardless if I lose anything prior to surgery.  And I always thought that losing weight prior to surgery was encouraged... so this whole thing about threatening to cancel my surgery seems a little strange. If anyone has dealt with Medicare or are familiar with their policy please let me know..
Thanks!!

I actually have Medicare, but I don't know their particular policy on this.  I do know that most insurance companies go with your weight at the consult.  Some surgeons actually want you to lose some weight before the surgery, and if your MBI then goes below 40, you usually still qualify for surgery.

Who told you if you drop below 40 you would be cancelled?  Medicare or your surgeon's office?  You might want to verify that.  But if that is the case, then I would just not lose anything.  It probably won't be hard to maintain your weight for just a couple weeks, will it?

Kelly

It was my surgeon's office that told me. I can maintain this weight but for some reason it's been hard. I am very motivated and it seems so counterproductive to not lose anything. I am going to call Medicare this week and ask. Thanks for replying!

If Medicare tells you they will go by your BMI at your consult (which is what I think they will do), I would ask them to fax that to you in writing.  Then you'll have it to show your surgeon's office.  You don't want to show up for your pre-op appointment and have to argue with them about whether or not your surgery should be cancelled if you lost a couple pounds. 

Plus it's just always good to get stuff from insurance companies in writing.

If you need to make sure you don't lose and it's a worry, I recommend adding a protein shake or two to your daily diet.  It will give you some calories but little or no fat, plus extra protein that will actually help you heal after the surgery.

Kelly

Thanks I will do that!

I had my surgery through my medicare 10 months ago and this is how it workd in my situation.  1st you must use a hospital that is considerd a center of excellence they will tell.  2nd you must meet all the requirements at the time of surgery.  ( if you must wear ankel weights hidden under your jeans for your final weigh in but remember they dont come higher than 5 lb.s so dont loose to much.  Medicare does not technically tell ur surgeon if u quailfy what they do is give your surgeon their prequalifcations list and as long as you meet all of them t the time of surgery they will foot the bill, so you and your surgeon take a gamble hoping theyll pay afterwards.  If you have a medicare HMO plan than for that one you have to meet all of their prequailifcations also and they will tell ur dr if you are prequilfied even though they are not the ones paying the hospital bill just the surgoeons.  I know it sounds like alot but i have 2 friends that went thorugh all this without medicare and theirs was more prequialifications than medicares.  Their was no isues with mne medicare paid in full.  Medicare is great in the fact that they dont make u wait 6 months like all other insurances, its one psyc visit, one nutriotion visit, and 1 pulmonary visit and with in 6 weeks ur good to go, once i picked a surgoen i had my surgery 2 months later!  Medicare is awsome about this and because medicare has this new policy where any mistakes the surgeon makes anything to fix it comes out of their pockets all the more reson for them to take extra special care with medicare patients, good luck to you!

Thank you for the advice. My pre-ops are on next Monday and my surgery is next Friday morning..I will be sure my weight meets the requirements!!
Thanks again
Patty