Medicare
Hello everyone! Well I have met all of the requirements to have WLS (psych eval, EDG, NUT..etc)...excited and nervous...Now I am waiting on Medicare to approve. I found some old posts about how long it takes but since things have changed I'm sure, I was wondering if anyone has had any recent experience with a time frame for them to approve. My surgeon said possibly August..... Just curious if anyone else has dealt with this. Sometimes I think I want it done yesterday and other days I can wait! I'm just fickle I guess. I do know I am doing this for ME. I want to live, be healthy, and enjoy my life again. Anyway, before I go on for days, thanks everyone and have a great week-end.
If you have regular Medicare, Parts A and B, rather than a Medicare Advantage Plan, they do NOT pre-approve WLS. If you meet the criteria, you just have surgery, the surgeon and hospital bill them, they pay their part, you pay yours. If you have Part C instead of A and B, then it would depend on which plan you have.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
WOW! That was quick. My first consult with the surgeon was March 21. What has held things up was the psych eval. He was backed up, then out of town. Finally when he did call, a week and a half ago I was in within a few days. Funny thing is, the surgeons office submitted my name to 2 psychs.....didn't know whether to be flattered that they really wanted me to have this done or thought I was nuts!! Either way, it's over..and I am completely Normal!! Fooled the psych!!! LOL!! So....I guess I could get a date sometime soon. YAY!!! I have to go see the NUT once again on the 20th...don't know why but I will do what it takes. Anyway, thanks for the info, Sandangel. I appreciate it.
I think the requirement of losing 10% is your doctor's requirement, though, not Medicare's, right?
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
No Kelly, 6 months diet and exercise and all the testing and NUT classes. 10% of my body weight. The only thing my surgeon required is that I be down to 350 before surgery. I also have part A and B of medicare. I also have to have copies of my diet and exercise that I log everyday and hand it in monthly when I go to weigh-in with my PCP. I dont know how some are getting the surgery done sooner. Wish I knew.
Brenda, I see you are in WV...me too!! I am in Nicholas County. Who is doing your surgery? Dr. Shin in Charleston is doing mine.....He just wants me to lose as much as possible to help him out. He told me that we are a team and we have to wrok together. I don't have to have all of that. His office told me that 3 months of physician supervised diet is all I need. Might be because my BMI is waaaaaay up there....I am talking over 50.
