medicare and VSG: anyone here approved?

would appreciate hearing from anyone who has gotten Medicare approval for the VSG

thanks

I don't believe Medicare covers sleeves.  Just bands and bypass, not sure about DS.

If you have standard Medicare I would not hold my breath :)

National Coverage directive only includes band, RNY, and DS

http://www.cms.gov/mcd/viewncd.asp?ncd_id=100.1&ncd_version= 3&basket=ncd%3A100%2E1%3A3%3ABariatric+Surgery+for+Treatment +of+Morbid+Obesity

There are also place of service restrictions - you must have it done at an approved facility.

but if they cover the DS, then can you not just have the first step done which is the VSG?  So, then, yes, Medicare will cover the VSG?

This original post is almost 3 yrs. old, but I have the same question.  Been searching high and low trying to find out what regional contractors will approve the VSG.  Medicare declined to give national coverage in a decision last June, but said regional contractors could approve.  I hear there are places/states out there that can/will do.  I desperately need the sleeve and do meet the medicare requirements, but can't find a state that will do it.  Indiana where I live is working on a regional level to get it approved, but I fear by the time that happens it will be too late for me.  I am already 68 with a BMI of 54.5 and multiple medical conditions including heart disease, hypertension and sleep apneas.  So if anyone out there has any current news.  Can we ressurect this thread?  Thanks.

Grannyfox:  One thing I read says this: For Medicare patients hoping to get the sleeve gastrectomy, Dr. Brengman encourages them to make sure they are heard: “Patients hold the key to access. If patients strongly desire sleeve gastrectomy in a particular region they should voice their support to their local contractor and demand coverage. Patients can look at their explanation of benefits statement to find out who their contractor is.”

I think it is too early to find a list of regions that accept Medicare for the sleeve (it was just put in place in October of 2012).  Maybe people will reply and say whether they have been successful in getting Medicare to cover it.  Alternatively, you can call your local Medicare administrator's office and see if they have a list.  Or, you can call a bunch of different "local" Medicare administrator's offices that are relatively close to you to see if they offer coverage.

Good luck!

Problem is, that is insurance fraud.  There was a doctor in TX that was caught doing that and he ended up paying all the insurance money back along with the patients.