vsg and medicare

Im not sure if this helps anyone, but a few times I have seen people ask if medicare covers the sleeve.  I am on my third doctor and on friday his office callled me to inform me that medicare will not cover the sleeve.  I moved here from 350 miles away because since the end of Feb they were assuring me that medicare would approve sleeve. I was assured after asking at least three times before i moved here April 23. I travelled the 700 miles round trip twice for office visits.The first negative thoughts that they even hinted that medicare would not approve was at my final surgeons con****ationon May23rd. I had been cleared by psych and nut and have all tests done from doc #2. At the consult doc went along with me on sleeve for about 15 minutes they subtly said what is your second choice in case we can not get sleeve approved. I knew right then that somthing was up so now after phone call on friday they have me scheduled for a consultation on June 20 and am trying to convince myself that it is NOT for the purpose of talking me into another surgery.  I am writing this to get it off my chest because I have been eating everything in sight since friday, but also to warn people that there is a good chance that if a program is telling you thary will do sleeve with medicare as your insurance be very careful, I have heard of people on here who have had the sleeve done with medicare but I sure cannot figure out how to get it done Good Luck to all in this journey

Contact Medicare and ask how to appeal the decision.  I'm not an expert but I have read other peoples posts where they appeal the decline citing medictions that they have to take that are not manageable with the RNY.    You're going to have to advocate for your self!

Hang in there.

Cindi

Hey!  Long time no hear from.  I am so sorry about all your problems and I hope it all works out in the end.  Thing is, for me, it was the co-morbities and a second consult with another surgeon that got Medicare to pay for my VSG.

I was approvede right from the start with my MediCADE but MediCARE required a second consult and  poof that at least two co-morbities cannot be controlled without the surgery.

I also needed my surgeon to say that any other type of WLS would be too dangerous or run too many risks for me in order to get the VSG.

I will keep you in my thoughts and pray you succeed in your quest. 

Good luck my friend!

Did you check the Illinois Forum?  Each state usually has listings of surgeons that accept Medicare and Medicaid.  Again, keep your head up and keep on trying!

Cindi

 If your surgeon is in agreement, book in for the DS -- and just don't go back for the 2nd surgery if all goes well with the sleeve portion.