Hi Everybody...A Newbie Here
Hi everybody, my name is Lena. I decided to stop lurking around the site and join it. I'm looking into having the RNY. I have Medicare and a secondary insurance and they both cover the surgery. When I finally decided to really going along with the surgery, I called Medicare and asked did they cover the surgery and what were the requirements. They said, it has to be at a center of excellence, and you have to have a bmi of at least 35 with a comorbiity. They also want to know that you tried to lose weight before. I specifically asked if the 6 month supervised diet was needed, she said no.
So when I heard that I was very excited. I took off this semester of law school so I can be well by the time classes start back in August. I then went to a bariatric center here in NC and got the SHOCK OF MY LIFE!!!! At the orientation, I was told that Medicare does require the 6 month supervised diet. I explained to the nurse that I spoke with someone at Medicare and was told they did not require it. The nurse then explained to me that its the local medicare that can also add restrictions for that state. ARE YOU KIDDING ME????? I don't have time for a supervised diet, Remember I have to go back to law school in August. So, I started researching other states and I found that NJ's Medicare doesn't require the supervised diet, so I'll be flying up there on Tuesday to meet with the surgeon. My PCP and the surgeon's office are already in constant contact. Let's see how this works out...
So when I heard that I was very excited. I took off this semester of law school so I can be well by the time classes start back in August. I then went to a bariatric center here in NC and got the SHOCK OF MY LIFE!!!! At the orientation, I was told that Medicare does require the 6 month supervised diet. I explained to the nurse that I spoke with someone at Medicare and was told they did not require it. The nurse then explained to me that its the local medicare that can also add restrictions for that state. ARE YOU KIDDING ME????? I don't have time for a supervised diet, Remember I have to go back to law school in August. So, I started researching other states and I found that NJ's Medicare doesn't require the supervised diet, so I'll be flying up there on Tuesday to meet with the surgeon. My PCP and the surgeon's office are already in constant contact. Let's see how this works out...
Welcome Lena and congratulations on taking that first step. I don't know much about Medicare in regards to requiring a 6 month supervised diet. But instead of seeing the negative aspect of this requirement, you should think about the positive. The first year after you have the surgery is the most important. At least I think it is. You're stomach will be reduced to a 6-8 ounce "pouch". Pre-surgery our stomachs hold about 40 ounces. You will be learning how to eat all over again. It will be mostly trial and error once you resume to solid foods. I still get sick sometimes and I will be 4 years out on Monday. Good luck to you. I will be waiting for you on the "losers" bench.
Sara
205 lbs lost
Size 32 to a 10-12
panniculectomy 3/11
Sara
205 lbs lost
Size 32 to a 10-12
panniculectomy 3/11
Thank you Sara. I wouldn't mind the supervised diet if I didn't have to start classes in Aug. I call myself preparing for the surgery and what I will have to do afterwards. I have only been drinking water for the last two months. For the past 3 weeks I've been less than 1100 calories and getting in as much protein as I can. I've lost 14 lbs. so far but I'm going to stop because I don't want to lose too much weight right now. Thank you for your encouraging words Sara!!
I would have thought the same thing. If you have NC Medicare, how does flying to another state give you that state's Medicare?
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.
Hi Kelly, this is the way that it was explained to me. I have regular Medicare, however, my Medicare is under the rules of the state that I am in. My state requires people on medicare to do the supervised diet, but NJ doesn't require the supervised diet for medicare in that state. I can choose any doctor around the country who takes medicare but the medicare rules will be based on that state.
So the rules are based on the state you have surgery in, not the state you live in? I would have thought it would be based on where you live.
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.
In case it doesn't work out for NJ, you can do school after surgery. I had my surgery on 1/6 and started back to school on 1/10. I went back to work on 1/20. I'm tired the last few days but I think it's just temporary. I just keep up on my vitamins, protein and water.
Start weight 226. Surgery weight 218 on 1/6/12
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