re: Medicare and WLS

Hi folks, I thought I'd just post quick to see if anyone has experience with Medicare and wls (yes, I know how to look it up, but thought this might be faster)

I had WLS a bit over 3 years ago... 150 pounds off and my mom age 69 is very interested in getting it done. DOes anyone know if Medicare covers WLS interventions??

Thanks for any responses and best wishes to all!

Linda

Yes medicare most deffinatley does!!  I am 66 had my surgery Nov.1 2011  They do require you to go on a three month doctor supervised diet before you will be eligible for coverage. Your reputable doctor should be able to help you with that.   Best of luck

 What do you mean by WLS interventions?

Medicare does pay for RNY and band. As of a few months ago they did not cover the sleeve but were considering it. There was a cut-off age of 65, but I think that was my bariatric center's rule. Oh, and there was no Medicare requirement to be on any diet beforehand.

I also checked several, times to be 100 % sure that Medicare covers WLS of the band, RNY and DS. They cover it for the inital surgery and for revison surgery. There is no psch eval requirement there is no diet requirement (except a history of failed weight loss attempts is required) also a co morbid if your less than say 40-50 BMI (can't remember which one). You must be 35BMI or higher. I don't know what you mean by WLS interventions but I know that they do not cover Nuts or diet centers for any reason other than the inital classes if you are a diabetic.

I had RNY on 5/9/2012. I am 70 years old. It was paid for via Medicare and my supplemental insurance HMO. I had to have a psychological exam and several other exams including a sleep study. I did not have to go on a diet. Many rounds of blood work. I had to have more than two co morbid and being fat did not count. High blood pressure and sleep apnea were mine. Good luck and I don't think seniors have any more problems than young folks do so that should not be a problem. Tell her to go for it as long as it is available.   

Yep.  Paid for mine.  It won't cover the sleeve yet, but covers other WLS.  You have to have a BMI of 40 or above, or 35 and above with comorbidities and must go to a Center of Excellence.

Medicare paid for mine, but be aware there may be some out of pocket expenses - you may still be responsible for surgeon's fees, nutritionist fees, nutrition classes, and the usual co-pays. It's still a bargain, and will help ensure her remaining years will be the best quality they can be (as you know!) I wish her the best of luck!

 Wow... thanks folks for all the replies.  What I meant by interventions were the types of surgical intervention... i.e. duodenal switch, RNY, sleeve, band etc....

I will let my mom know.  This is going to really give her some hope.  She has a variety of co morbid conditions, is looking at needing a double knee replacement very soon.  Here mobility is becoming worse and worse because of the pain from the weight coupled with the pain already there from degenerative joints!

Hopefully she'll get the ball rolling....  I just am of the opinion that if she could get significant weight off before the joint replacements... her recovery would be soooo much better.

Thanks again for all the replies!
Best wishes to all for continued success!!