How long did it take for medicare/supplemental insurance to approve roux en y for anyone out...

netnay
on 2/9/13 3:02 pm
RNY on 03/27/13

I have the blue cross blue shield supplemental insurance through Medicare. I had to do the 6 month supervised visits through my primary care doctor in order to be considered for gastric bypass. I was wondering how long did anyone who is on Medicare had to wait for their decision. Thanks so much.

Jamie

poet_kelly
on 2/10/13 5:48 am - OH

If you have Medicare parts A and B, I don't think they pre-approve surgery.  They didn't want I had mine four years ago.  But they didn't require a supervised diet first, either.

When you say you have supplemental insurance from Medicare, are you talking about Medicare Part C?  Or you have some other insurance and have secondary insurance through Medicare?  I don't know how that works.

View more of my photos at ObesityHelp.com          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.

 

netnay
on 2/10/13 12:03 pm
RNY on 03/27/13

I have part a,b, and c through medicare. I was told that it was a requirement for me to do 6 months of supervised dieting and weigh ins. I did my final weigh in 2 weeks ago. My surgeons office told that they would probably get back to me last week to put me on his schedule. I have not heard anything yet. I don't want to keep calling and getting on their nerves. lol.

docputer
on 2/10/13 5:55 am - Topeka, KS
DS on 01/17/13

Mine was a DS, Not RNY, It took 28 days for approval

        
netnay
on 2/10/13 12:04 pm
RNY on 03/27/13

I am patiently waiting. It seems like my 6 months of weigh ins flew by and that waiting on the decision is just dragging.

juleskar
on 2/10/13 6:24 pm
I had Medicare with a supplemental 2ndary insurance. Yep, I had to do the 6 month dr supervised diet. Had to list all of the diets I'd tried in the past. Did the psych eval, nutrition class, initial dr/WLS class/seminar, lab work, EKG (I think that was all). Surgeons office submitted paperwork to Medicare for approval. It took about a week or 2, but I was approved with the first request.
netnay
on 2/11/13 5:04 am
RNY on 03/27/13

I have done all the required testing and nutrition classes as well. Just the waiting to see if i am approved is getting to me. I'm glad I found obesity help. Getting my questions answered makes me feel better.

southernlady5464
on 2/10/13 9:13 pm

I didn't have to do the 6 month diet...mine was BCBSTN thru Medicare.

And while Medicare does not approve surgery but usually pays afterward as long as you qualified, most companies that have the supplemental for Medicare DO require pre-approval.

I was submitted in Sept, approved a couple of weeks later with BCBSTN but by then had changed my surgery AND my surgeon...so it was a couple of months later...We also had my dh going in and his was scheduled for mid Dec...so I waited an extra 5 weeks after is to have mine.

Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135






   

netnay
on 2/15/13 3:54 am
RNY on 03/27/13

I heard from my insurance and my surgeon's office today. everything has been submitted to my insurance company. Now all we haev to do is wait on the authorization from my insurance. From what I know they are saying mar 20 for my surgery date, but nothing is set in stone yet. They are waiting for a yes from the insurance company before they say for sure!!angry

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