BUMMED!!!!

I went in the 15th for my consultation with Dr. Lauter in Kirkland, and let me tell you!!! I had to brave Steven's pass and for what???? To find out that I'm not sick enough from my obesity for Dr. Lauter to agree to do the surgery without getting $7,000 from me up front. I understand and appreciate that this is a business as well as a service, but I feel so disappointed!! I guess my next move is to have my PCP do all the testing Dr. Lauter wants, and HOPE I am sick enough eventually for him to go ahead without the initial $7,000. I wish they would have told me this on the phone...it would have saved me a very stressful trip over the pass and my hubby a day from work. I am feeling disheartened and, I'm not afraid to say, a bit depressed. I'll just have to get ahold of my PCP and find out what to do now. I guess I am mostly frustrated with Medicare, as they are the ones placing the requirements on this surgery in order for them to cover it. I am TRYING to keep my head up, but as you all probably know it's difficult. I want to thank everyone for the good wishes and prayers for my trip over that pass, thank the Gods it was uneventful!! I have a few questions about Agoraphobia, Hidradenitis Suppurativa and their influences on WLS. If any of you have any information, feel free to contact me!! Thanks!!! Cindy in Wenatchee

Cindy, I have a friend trying to get Medicare approval. She was about a week away from getting her approval almost a year ago when Medicare changed the rules. She is now getting close to having finished a 6 month supervised diet which is one of the new requirements. She has several co-morbidities including diabetes and super morbid obestiy and she is having a hard time too. What I don't get is. . . can't the insurance companies see that it will cost them less in the long run? Sorry about your disappointment but I wouldn't give up. Karen

Don't give up Cindy!!! Talk to your PCP and discuss options. Are you saying that you don't have the comorbidities that qualify you? There are several things that are considered co-morbid conditions. Even varicose veins! Keep your chin up girl!! This will all work out for you I'm sure. If you have questions or concerns, know that we are all here for you!!! Good luck to you and happy holidays!!!

although it is a long drive, Try Dr Bright in Spokane.

Dear Cindy, So sorry to hear about your trip to Dr Lauter. Keep that chin up! I have Medicare, and had surgery on Oct. 12th. Medicare does not pre-authorize, so all you should need to do is find a Doctor who accepts medicare. As long as you have co-morbidities as outlined by Medicare, they will cover it. What are your co-morbidities? Off the top of my head, asthma, sleep apnea, high blood pressure, diabetes, I think these are all co-morbidities that will support WLS.... but I'd have to look them up to be sure. My girlfriend has Medicare as well and she used Dr. Hunter from Virginia Mason in Federal Way.. and I used Dr. Thirlby of Virginia Mason in Seattle. Are you sure you have Medicare, or do you have Medicaid?? I was so confused by these two, when I started researching WLS I thought I had Medicaid, which require the six month supervised diet. Then I found out I had Medicare, and it was a breeze. My primary physician typed up a letter of referral for WLS, I took it to Dr. Thirlby, and within two months, I had my surgery. Virginia Mason Doctors handle everything with Medicare, I never had to deal with them at all. If you truly do have Medicare and supporting co-morbidities, I believe you'll have no problems! Cindy, you are so beautiful, don't get discouraged! You deserve this surgery and you will find a way! I read your profile and I understand how you feel, if you ever want to talk, I'd love to hear from you Let me know how it turns out please! XoXo~ Kimanne