Need Help!

Joyce P.
on 8/6/13 9:14 am - Halifax, VA

DS on 11/07/14

Hello!

My doctor's want me to have weight loss surgery, but hubby's Ins. co excludes it from his plan all together even if it is medically necessary. I have Medicare as my secondary insurance. Does anybody know how or if Medicare would help or even pay for the surgery?

Joyce P
Halifax, Virginia

poet_kelly
on 8/6/13 9:25 am - OH

RNY on 11/04/08

Medicare does cover WLS. With that being your secondary, I'm not sure how that would work. I don't know if Medicare will cover it if your primary doesn't or not. I could call the 800-MEDICARE line and ask about it.

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.

Nutterbutter
on 8/6/13 9:25 am - NJ

I have Medicare and it paid for 80%

Joyce P.
on 8/6/13 10:09 am - Halifax, VA

DS on 11/07/14

My hubby's ins is Primary, so my Medicare will only pay 50%!

Joyce P
Halifax, Virginia

DebsGiz
on 8/6/13 11:11 am - FL

Have you actually called the folks at Medicare and spoken to them about this because this just does not sound right to me?

If you want to know for certain exactly what to expect, give the folks at Medicare a call because anything you are told on here would likely be a guess rather than the actual facts, and you need to know the facts I'm thinking.

I deal with Medicare in my job all the time and have found the folks that work there to be extremely knowledgeable and willing to assist, so please give them a call if you have not already done so.

Good luck on your journey!!!

selhard
on 8/6/13 10:01 am - MN

RNY on 11/26/12

Couldn't help notice you wrote "doctor's want me to have wls" and wonder if YOU want to have wls? A friendly suggestion is to make sure YOU want the surgery first and foremost. Good Luck.

Joyce P.
on 8/6/13 10:08 am - Halifax, VA

DS on 11/07/14

Yes, I have been thinking about it for a long while now. It is time to move in that direction, but if Medicare won't pay, I will not be able to afford it!

Joyce P
Halifax, Virginia

babs_02
on 8/6/13 10:30 am - NY

I have Medicare for a disability and my husbands insurance was my primary until my Medicare came into effect and then his insurance became secondary to my Medicare. Medicare paid for all of my RNY.

purpleswingline
on 8/6/13 10:42 am - Fayetteville, AR

RNY on 08/26/13

I have Medicare Advantage plan and they are paying 80% of it and all of the surgeon fees. Leaving me with only $ 1,643.54 to pay! Thank goodness for Medicare or I wouldn't be able to pay for it either.

Joyce P.
on 8/7/13 3:03 am - Halifax, VA

DS on 11/07/14

I called Medicare this morning and got good news. They said that even if my Hubby's ins doesn't pay, they would have to file with his first and then with medicare and they would pick up and pay for the surgery. There is a deductible of $1,184.00. I am nervous and excited. I don't even know what to do next in this process. Do I go to PCP and get them to write letters of Medically Necessity? What is the next step for me? Help???