WLS and Medicare, Your experience and help are appreciated.

So, my surgery will be funded by Medicare.  I do not currently have an Advantage plan nor a Supplemental plan.  I haven't chosen one simply based on the cost to add it as well as not really  understanding how they work and getting near to no advice from the Medicare office.

I am hoping to speak with those that have also gone this route and had to use Medicare for surgery.  As I am right now, I am paying 20% out of pocket for this.  Some services, such as the dietician/nutritionalist will not be covered and must be paid at 100%.  I live in Oregon, so if anyone has any experience with this or has done this with the addition of a supplemental or advantage plan, I would really love to hear from you.  This is going a bit faster than I anticipated.  Lab work is Thursday.

I suspect if I'm gonna amend my Medicare plan it needs to be BEFORE surgery.

Thanks in advance for your thoughts.

A Medicare Advantage plan would mean you signed up for some sort of HMO or other plan INSTEAD OF Medicare Parts A and B.  You can ONLY change to a Medicare Advantage Plan during the open enrollment period, which is at the end of the year.  You can't do it right now.

Depending on the plan you choose, it might have different requirements for WLS than straight Medicare, which is what you have right now. 

A supplement is an ADDITIONAL policy you would purchase that would help pay for stuff not covered by your Medicare parts A and B.  If you want a supplement to help pay for your WLS, yes, of course you would have to buy one before you have surgery.

Right, I am still in my allotted "choice" phase since my insurance just kicked in June 1st.  That's a simple way of looking at it, I didn't realize the advantage plan takes place of Medicare A & B.  I thought they worked together. 

Guess if I am gonna need help paying my 20% I should look at a medigap plan.

No, the Advantage Plan, also called Medicare Part C, is an alternative to parts  A and B.

Enrollment periods vary, depending on when you became eligible

http://www.medicare.gov/sign-up-change-plans/when-can-i-join -a-health-or-drug-plan/when-can-i-join-a-health-or-drug-plan .html

Actually the Advantage plans replace A & B

http://www.medicare.gov/sign-up-change-plans/medicare-health -plans/medicare-advantage-plans/medicare-advantage-plans.htm l

http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/167/~/di fferences-between-medicare-parts-a,-b,-c-and-d

Medicare Advantage plans have other enrollment periods as well depending on when you you became eligible for Medicare. Also Medicare Advantage plans come in all varieties such as the HMO mentioned but PPO and Fee For Service. Everything depends on what is available in your county in your state.

Most Medicare Advantage plans pay 100% of WLS as long as you meet the criteria.

Individual surgeons may have fees that are outside of the "normal", usually called "program fees".

I took a quick look at your profile, and I'm going to give you some advice: Find yourself a surgeon who does the Duodenal Switch. You have a BMI of 94. The DS is your best chance of reaching a 'normal' weight and STAYING there. The DS has the same stomach as the VSG, plus an intestinal bypass similar to, but more effective than, that of the RNY/gastric bypass. It causes permanent metabolic changes, and permanent malabsorption of a significant per centage of the calories you eat. It is also the most effective form of WLS at resolving or preventing co-morbs like diabetes and high cholesterol.