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I am in the beginning process of this journey, I am required to meet with the nutritionist for 3 months and my BMI is currently at the qualifying range of 35.5. My question is if they put my on a meal plan for the next 3 months and my BMI falls below 35 will I be not eligible for bariatric surgery or do I need to try to keep my BMI at 35 during this 3 month process?
I met with a bariatric surgeon last week and based on my BMI and Sleep Apena he told me that I was an eligible candidate. He provided me with information and referrals to see a dietitian for 3 months and a psychologist both within the practice. My question is do I have to go to the psychologist that he referred me to or can I choose to look else where as long as they specialize in bariatric surgery exams and are able to send him the report.
Hello Hector,
Here is what we found for you.
Medicare covers certain types of bariatric surgery if you have certain factors related to morbid obesity. To be eligible, you must:
- Have a body mass index (BMI) of at least 35 kg/m2.
- Have at least one obesity-related medical condition, such as diabetes type 2.
- Have tried other treatments for obesity and been unsuccessful.
- Get the surgical procedure at a hospital or facility that has been certified by the American College of Surgeons as a Level 1 Bariatric Surgery Center or as a Bariatric Surgery Center of Excellence.
Here are additional medical conditions.
Have at least ONE of the following diagnosed health conditions
- Type II diabetes mellitus (by American Diabetes Association diagnostic criteria).
- Refractory hypertension (defined as blood pressure of 140 mmHg systolic and/or 90 mmHg diastolic despite medical treatment with maximal doses of three antihypertensive medications).
- Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications).
- Obesity-induced cardiomyopathy.
- Clinically significant obstructive sleep apnea.
- Obesity-related hypoventilation.
- Pseudotumor cerebri (documented idiopathic intracerebral hypertension).
- Severe arthropathy of spine and/or weight-bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for the obesity).
- Hepatic steatosis without evidence of active inflammation.
When you are ready let us know if you need any further assistance like finding a surgeon.
Take care,
Kathy
Member Services
HW:330 - GW:150 - MW:118-125
RW:190 - CW:130
Hello my name is Hector I little about me, I am 30 years old 5"7 227 lbs BMI 35.5, I suffer from GERD, High liver enzymes and I also have High cholesterol levels.I am interested in bariatric surgery I have tried on my own to lose this weight have tried diet programs such as slim fast, nutrisystem, joining gyms and medication and have been unsuccessful. I would like to know if anyone knows what are Medicare's requirements to have bariatric surgery covered and a full list of comorbid conditions that are associated with obesity. I have tried to get the information directly from Medicare but they are vague with the information they provided. Only conditions that I am aware of is Sleep Apnea and Hypertention in which I do not have. If anyone has anyone any information I would really much appreciate it. Thank you.
I'm in Hudson County and I'm having trouble finding a surgeon who accepts this insurance. My pcp is ready to sign off on whatever needs to be done, but I can't find a surgeon! Does anyone have any recommendations for a doctor in or around the Union City/Jersey City/North Bergen/Hoboken area? Or even within a reasonable driving distance? I'm at my wits end with research and making phone calls and if anyone has any advice I would greatly appreciate it.
Dr. Foreman
I had Medicaid - Paramount advantage
Mercy Weight Management Center
3930 Sunforest Ct #100, Toledo, OH 43623
A few years ago I had band surgery, and was very successful. Now I think my band has outlived it's usefulness, and I am looking into getting a gastric sleeve.
Can anyone recommend a good Sleeve Doctor? I am doing my research, but would like to "talk" to those who have had "personal" experience.
I'm looking for a doctor that take Horizon NJ Health. I've called them 3 times and they would not provide me a list of physicians in my area. I'm in the Hamilton/Princeton area. All feedback is welcomed
I am curious about this, too. I'm reading posts on here, but they are a few years old.
I just had the barium swallow and endoscopy so I am going to send that to Dr. Alvarez at Endobaritric in Mexico. My friends and family are freaking out over that.
I feel hungry all of the time and can eat way more than fellow sleevers. I feel like I've thrown away this chance at regaining control.
Can't wait to hear more current stories!
