Medicare and Revisions?

Has anyone had a revision with Medicare? (not medicaid)  It was a breeze getting my first surgery paid for but I wondered how or if they would pay for a revision?

Hello CC,

Not sure about revision coverage but I did find an old post from Medicare/Medicaid sticky on Indiana's forum that states as of 2/28/08 that she accepts your insurance. Good luck!

Post Date: 2/28/08 10:26 am 
Dr. Margaret Inman
11725 Illinois Street Suite 240
Carmel Ind 46032

317 814 4580

Accepts medicare

Medicare covers revision, as long as you still have a bmi over 35, or have medical reasons.

Teri

 Hey thanks!

Medicare does cover revisions, but you have to meet their guidelines.  I'm in the process of seeking a revision.  Follows is the guidelines that the surgeon I'm using(Dr Robert Marema in St Augustine Fl) gave me:

BMI >= than 35
One or mor major Co-morbidity(hypertension, sleep apnea, diabetes type II)
Procedure(Laparoscopi Roux-en-y, Gastric Bypass, Laparoscopic Adjustable Banding 
             or Revision) must be done at a Center of Excellence
Physician supervised diet, consisting of monthly office notes regarding plan for diet &
            (exercise regimen if medically feasible) 4 months unless secondary insurance dictates
             otherwise
Psychological Evaluation
Nutritional Consultation
TSH-thyroid panel(blood work)
Letter of Medical Necessity from Primary Care Physician

Hope this helps.

I have 2 more months of diet and nutritional counseling done, then I can have my revision.  I am having a revision from VBG to RNY.

Dorothy

Wow that is great!!!!!!!!!!  Do you know how I can get a copy of the Medicare guidlines?  My insurance has denied my revison.  I know they follow medicare guidlines....

Thanks so much,
Cheryl

Sorry it took so long to respond.  Just seen your post today(8/27/10).  I got my copy of medicare requirements from Dr Marema's office at the seminar he gives.  I don't know where else you could get them.  But, except for the typo mor(was supposed to be more), I copied them exactly word for word.  Hope this helps!

Dorothy

Dorothy,

Thank you.      I am  sure it will help me..

Cheryl

This is GREAT info!  Thanks so much.  Sorry it took me a while to even see it...things have been busy at my house.  Good luck to you!  My revision will be from RNY to DS...or some version with a SLEEVE.  I need the sleeve for medications that my pouch will not tolerate.