Question:
Has anyone been approved on Medicare?

I have been on disiability for 2 years. I just found out that after you are on disibility for 2 years you automatically go to medicare. I am 58 years old,I worked for 30 years at one place and become disable to do the work any more.I have Aetna hmo ins until Aug 1 then medicare takes over. I woul appreciate any feed back on this matter. Thanks    — Patricia Stephenson (posted on May 18, 2005)

May 17, 2005
Hi Patricia! I know of several people in my area (Portland, Oregon) who have had Medicare cover their BPD/DS surgery. Be sure to ask your surgeon's office staff (particularly their insurance person) if they have experience working with Medicare. Oftentimes the big determining factor is whether or not your surgeon is willing to accept what Medicare will pay. Blessings, dina
   — Dina McBride

May 18, 2005
medicare does not preapprove. If your doc deems it medically necessary, they will pay. medicare is an 80/20 program with you paying the 20. Try to find a surgeon that takes MEDICARE ASSIGNMENT. Don't just ask if they take medicare but if they take medicare assignment, This means they cannot charge you over what medicare pays them. They have to write it off. medicare pays better than any of the other insurances as far as you DO NOT have to be preapproved or have referrals or anything. All you have to do is start calling around to find a surgeon and set up your appointment. Look for bariatric surgeons in the phone book or go to the "find a doc" section here in the site and look for those in your state that take medicare. Do.t forget to ask about ASSIGNMENT.
   — Delores S.

May 18, 2005
Hi Patricia. Yep!! Medicare paid for my Distal RNY here in Alabama. No questions asked. Never had to deal with them at all. Just went to the doctor and they took care of everything. Email me if you'd like. Cindy
   — cindirella

May 19, 2005
Hi Patricia, Mediacare did pay for my RNY. My requirements were to get all of the pretesting done and then I was denied once they submitted. I then appealed and had a phone interview to appeal, during the interview I added that I was recently diagnosed with sleep apnea. This new diagnosis caused me to be approved because it then became medically necissary. Now, I don't believe it was medicare itself that denied me... I believe the hospital does that. Then after the surgery medicare pays. Talk to your surgeons office, they know all of the ins and outs of it! Good luck and have a great day.
   — septembergirl73