I NEED A REVISION!
(deactivated member)
on 8/15/12 10:06 am - WA
on 8/15/12 10:06 am - WA
I live in Washington State, I am bewildered as to why GA would have such a clause as Medicare is a Federal Program. I called in 5 times to ask the same questions on whether Revision is covered and how just to make sure the person knew what they were talking about and I was never asked what state I live in. I mean maybe they could tell by my phone number I suppose. Have you called them?
(deactivated member)
on 8/16/12 11:21 am, edited 8/16/12 11:22 am - WA
on 8/16/12 11:21 am, edited 8/16/12 11:22 am - WA
wow I guess it does make a difference what state your in. When I call in (and I know from my first WLS) that the requirements to a revison are Bmi 35, previous failed diet attempts as stated by your PCP ( a letter or chart notes works for even one disscussion with him), and at least one co morbitity of which they have a list and having it done in a center of excellence. Nothing else is required and they do not pre approve, just if you meet the requirements then you are covered. I specifically asked if revisons were covered and they told me (each time) that it is the same as any other surgery. If they have to go in and do it again or fix it it is covered. But maybe, are you talking about state medical, medicad?
No, I have my Medicare through Social Security, I started receiving Medicare at age 50 through SS disabled widows benefits . I was diagnosed with degenerative scoliosis in 1992. They said I'd be in a wheelchair by 40 if I didn't get my weight down. Medicare payed for a power chair for me a few years back, it was so painful to get around. I have the red white and blue Medicare card, part A and B.
I have GA State Medicaid as my secondary.
I hope it all goes well!
I have GA State Medicaid as my secondary.
I hope it all goes well!
I too remember you. We were there togeather. Sorry we are now in the same boat togeather too. I am getting my band out on 9/4. Not sure what will happen after but, the band must come out one way or the other.
BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.
The surgeons office told me to try calling a few times a week to see if I can get in to see him before 9/4, I hope I can! But the 4th is better than nothing! I'm still sweating out the Medicare/Medicaid approval issue but from what I've been told for the most part, if my 1st WLS (My LapBand) has caused serious medical complications (and mine has!) than Medicare will pay for removal of the band and revision to a RNY. I won't count on anything til I hear it from the surgeon, but I'm feeling hopeful! This is week 4 of nothing but liquids, 3 protein shakes a day and as much vitamin water 0 as I can drink. It's been hard but anything mushy makes me nauseous and anything solid, even a soft scrambled egg, just won't go down, and I throw up......not sure if its the slipped band or the previously repaired hiatal hernia that's ruptured that's causing the most problems, but either way the band has to go and I need a revision, another band is NOT an option! Good luck to you, keep us posted on your surgery and recovery :)
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