Question:
Who submits a letter to Medicare to see if they will cover roux -n- y surgery?

Do I submit one or my doctor? Where do you send it and to whom do you send it? What to include?    — Shari B. (posted on March 12, 2005)

March 12, 2005
medicare doesnt pre authorize. Your surgeon does the surgery then submits the claim.
   — star .

March 12, 2005
MEDICARE DOES NOT PRE-APPROVE ANY ONE TELL YOUR DOC TO DO THE RNY OR WHAT EVER HE WANTS AND THEN SEND IT TO THEM. THEY WILL TELL YOU IF YOU HAVE MEET THE AMOUNT YOU PAY OR NOT AND IF SO THEY WILL PAY FOR IT IF NOT YOU WILL HAVE A CO-PAY. TODAY I GOT MY LETTER SAYING THAT I HAVE NO MORE CO-PAYS SO I AM GOOD TO GO JUST WAITING ON A DATE WHICH I SOULD KNOW THIS WEEK.
   — ritamytweety

March 12, 2005
Everyone is right. medicare does not pre-approve. After your surgeon does all your pretesting he sends a letter of medical necessity to them and they will pay if it is necessary with no questions asked after your surgery. No need to worry about them not paying if it is necessary and your surgeon will see to that.
   — Delores S.

March 13, 2005
My Dr's office took care of everything. I was told if you have a BMI of over 37 with co-morbidities they will pay for it. I didn't have to deal with them at all and it was all paid for my Medicare and AARP. If you don't have supplemental ins then you will have to pay the $840.00 hospital copay if you haven't already paid it. Hope that helps Jo
   — Jo Marie M.

March 14, 2005
Mdiecare will pay for ANYTHING your doctor will say is 'medically necessary', but---you need to be certain that your surgeon will accept Medicare ASSIGNMENT. This means that he can't charge you more than Medicare's 'reasonable and customary' fees.
   — MsBatt

March 15, 2005
I was wondering about the supplement insurance. Who has a good suplement, and how much are they usually?? If you have it, does it mean you dont have out of pocket?
   — bawana

Click Here to Return