Medicare question!

LindaM1962
on 2/21/17 12:04 am

Hello everyone! Several years ago, I was part of this site, doing research and hoping and praying my insurance would approve me for the surgery. Unfortunately, it never happened. In 2011, I became a widow and then 2 yrs later, I was approved for my disability. Along with the disability decision, I also became eligible for Medicare, and over the last 2 yrs, have tried to find a way to get this surgery. FINALLY, after about 15 yrs of trying, I finally got the call that informed me that Medicare WILL cover the surgery!! I was ecstati****il I got the paperwork from the weight management facility! It states that PRIOR to the surgery any co-pays, deductibles, etc, etc MUST HE PAID in full. Has anyone else had Medicare for the surgery??? If so, did you have to pay the 20% co-pay prior? Any and all help and info would be greatly appreciated!! 

LindaM1962

dagosson
on 2/21/17 5:06 am

Do you have parts A and B? If so, call your Medicare part B provider and ask them to break down the costs for you :)

RNY 9/28/16 at Highland Hospital with Dr O'Malley

LindaM1962
on 2/21/17 6:49 pm

I have both parts A and B. I called Medicare, they told me I'd be responsible for 20%, but that until the surgery was performed, the facility can't submit it for payment! I'm wondering if maybe they want me to pay the 20% and then bill Medicare for the entire amount???? Just a theory!

 

Linda

Grim_Traveller
on 2/21/17 5:45 am
RNY on 08/21/12

It isn't medicare that is requiring payment up front. It's the hospital and/or weight management people. Lots do it this way. They get tired of chasing people after surgery and trying to get payment -- or they never get their money. So, they rwquire the money up front, or they won't do the surgery.

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

Valapp
on 2/21/17 8:45 am

I had Medicare Part A and B plus a medicare supplement policy.  My surgery was paid for 100%, nothing out of pocket. 

HW 280

CW 168

Goal 165

Kathy S.
on 2/21/17 9:35 am - InTheBurbs, XX
RNY on 08/29/04 with

Hi Linda,

Welcome to OH!  There are no words to say how much your journey to weight loss surgery has touched us.  FINALLY!  Grim is correct, this is a surgeon/facility thing not Medicare.  PM me where you are located and I will see if I can find some other surgeons in your area that takes your insurance.

Looking forward to hearing from you  

HW:330 - GW:150 - MW:118-125

RW:190 - CW:130

LindaM1962
on 2/21/17 6:46 pm

I'm located in southern Indiana. Louisville, KY, Mt. Carmel, IN(I think), Evansville, IN areas. There was a surgeon in Louisville that was doing the surgeries, but he has since moved to another area and is no longer available. Thanks for the help! I look forward to receiving any info you might find. I have both Medicare A and B.

 

Linda

Kathy S.
on 5/9/18 11:52 am - InTheBurbs, XX
RNY on 08/29/04 with

Hi Linda,

Try this surgeon. They take medicare.....

avatar

John S. Oldham, Jr.
Baptist Health
Louisville
Phone: 502-894-9499

HW:330 - GW:150 - MW:118-125

RW:190 - CW:130

EllaRichie
on 5/9/18 12:38 am, edited 5/8/18 5:38 pm

Hello there! Sorry for replying late, but I think that you need to contact the insurance agent and ask them about to cut the cost. One of my friends is having the same problem, so he contacted the insurance agent of this site and get the help regarding cost and coverage. Medicare Part A and B plus a Medicare supplement policy also work well for cutting cost of surgery.

LindaM1962
on 5/10/18 10:53 am

Thanks for replying. I had my surgery 12/13/17. I was responsible for just over $600 prior tothe surgery. Since then, i've received a book for $1300 and working on getting it paid.

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