Good News! Need More Help!
8/6/2013
Hello!
My doctor's want me to have weight loss surgery, but hubby's Ins. co excludes it from his plan all together even if it is medically necessary. I have Medicare as my secondary insurance. Does anybody know how or if Medicare would help or even pay for the surgery?
8/7/2013
Hello!
I called Medicare this morning and got good news. They said that even if my Hubby's ins doesn't pay, they would have to file with his first and then with medicare and they would pick up and pay for the surgery. There is a deductible of $1,184.00. I am nervous and excited. I don't even know what to do next in this process. Do I go to PCP and get them to write letters of Medically Necessity? What is the next step for me? Help???
Joyce P
Halifax, Virginia 
I'm assuming you have Medicare Parts A and B, not a Medicare Advantage Plan? If so, you don't need a referral from your PCP. You can just contact a bariatric surgeon and make an appointment. Some surgeon require you to attend a seminar at their office before scheduling an appointment for a consultation, which they will tell you when you call them. Of course, when you call, make sure to ask if they take 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.
My PCP also wanted me to have the surgery. She gave me a list of bariatric surgeons her office had dealt with in the past and recommended. I then called the one that best suited my needs, attended a seminar which was required and then scheduled my first appointment. At that appointment they gave me a packet that outlined everything I needed to do prior to surgery such as the letter of medical necessity, psych eval, etc. After getting all that in they got the insurance approval and scheduled the surgery. They had me do a few things extra because of my age (62) but everything went smoothly. Good luck.
Karin
