Medicare living in San Antonio, Tx??

I just had my RNY in January covered by Medicare and there was no supervised diet. I agree that the info you have must be either from your surgeon or you're getting Medicare confused with Medicaid. Medicare is a federal program and the rules are the same in all states; Medicaid differs from state to state. 

Is the paperwork from Medicare or from your surgeon.  I can find no reference to pre-op diet anywhere on Medicare website.

If you have that please link me to it.

Becky

Hi Becky..
Well I believe u when u say that we don't have to do the diet. I'm calling my advocate from the facility where I go to check in from my diet & going to confirm w/her. This is so stressful. I guess this is the beginning of 1 of the obstacles I have to go thru for this surgery. If this is a requirement... Well guess what?? As I was typing this up a phone call from my advocate came thru. She did confirm that it was a major requirement now to have a 7month diet regimen and documentation of excerise. She had the pamphlet in front her & assured me that Medicare (for Texas) was requiring this. She said that 2010 they were going to check every nick in tooth to make sure patients met all requirements due to past instances where having patients at times not meeting all of Medicare requirements but patients still had the surgery. People that didn't do the diet regimen for 7 months (in Texas) & had the surgery was a mistake on their (Medicare's) part and no longer want to make mistakes again.. Let me know what u think pls..

Looking forward to ur response on this
Rachel

There is no "Texas" Medicare.  Could you be talking about Texas Medicaid?  I have looked for any 2010 changes in Medicare rules for bariatric surgery and just can't find it. 

Medicare is what seniors and people on SSDI get.

Medicaid is what people on SSI get.

Maybe that is the confusion?

Becky

MediCARE is the same everywhere---it's a Federal program. MediCAID is a state program, and the rules vary from state to state. If you have MediCARE, then you don't have to do a pre-op diet and you can't get pre-approval.

I'm also going to suggest you consult with a different surgeon, one that does the DS. Given your BMI, the DS is likely a far better choice for you than the RNY.

As others have said, there is not such thing as Texas Medicare.  There is only one Medicare and it is the same in all states.  Do you have Texas Medicaid instead of Medicare, by chance?

If you have Medicare (you have a red, white, and blue card?  You are over 65 or are on Social Security Disability Insurance?), call Medicare at 1-800-633-4227 and ask about their requirements.  

If you have Texas Medicaid (probably because your income is low?  Or you are on SSI?), you may be required to do a diet.

Kelly

I have Medicare due to SSA Disability. I told her(my advocate) that I have been talking w/fellow members of OH whom have gone thru this process and that I am getting info that is not coinciding w/what they (my advocate) is telling me. I xplained to them what u have told me she told me that from Medicare it was a requirment that its always been this way. I went thru Medicare.com and It does state it on their rquirement fields that diet regimen is requirment plus that I have to have 1 or more of co-morbidities as well. They did let me know that there was no pre-auth as u've said but for some reason this diet requirement is still in question for me. I will call again tomorrow and I did call Medicare spoke to a rep there they even told me that they didn't see it on there comp info either however I did see it on Medicare.com it does state it on there... I looked at everthing today my card red, white, & blue card I have partA & partB entitlement. I will keep u posted of what I may find tomorrow. Thanx for ur responses I really appreciate all of ur feedbacks. I really do.

Rachel