Did ANYONE get MEdicare to pay for VSG?

grisaille
on 2/29/12 9:43 pm, edited 2/29/12 10:06 pm - NC
Well, seems like I've been hearing horror stories that Medicare will never pay for my VSG.  I was approved for DS but doc could not perform and here I am.  I have been advised not to stir things and say, call MEdicare and ask what they are going to do or even call my doc's insurance folks.  Being 7 days out and not knowing if you face such a financial debt is overwhelming me . . .
            
HW 369  SW 369 GW 199
Traci M.
on 2/29/12 11:44 pm - CT
VSG on 03/13/12
My friend had Gastro by pass and she had state insurance I'm not sure if that's the same thing but they paid.She lives in CT.I don't know about NC but t me it dosent hurt to check!

Traci

        
Jamie_45
on 3/1/12 12:26 am - CA
VSG on 01/09/12
I am on medicare and have Kaiser Permanente Senior Advantage as my supplemental.  They paid for mine with no problems... good luck and hope they approve you.
    
    
grisaille
on 3/1/12 12:37 am - NC
Wow - you are a ray of sunshine !!
            
HW 369  SW 369 GW 199
Mom4Jazz
on 3/1/12 12:52 am
Even if they don't typically pay for a planned VSG (which I don't know if they do or don't) you should be able to appeal it successfully because of your situation.

I agree don't make a stir. Hopefully it will just go through. I know you'd feel better knowing for sure, but you might bring undue attention to it if you do call them.

Highest weight: 335 lbs, BMI 50.9
Pre-op weight: 319 lbs, BMI 48.5
Current range: 140-144, BMI 21.3 - 22

175+ lbs lost, maintaining since February 2012

cracsgrl
on 3/1/12 1:26 am
 I would think if they pay for DS that the would cover VSG since its basically step one in the DS. My mother had them pay for her Lapband. And Medicaid paid for my VSG. Texas medicaid just recently started paying for it though like the middle of last year. If they don't cover it now they may in a few months. In the mean time screw stirring the pot BLOW THAT PHONE UP and keep doin it till  you get the answers you seek. Its your health and you should be able to be your own advocate. Me calling my insurance company is how I found out my Drs office had not even sent in my paper work yet and when I called them to ask about it the nurse that handles that stuff just got swamped that day and over looked my file. 

    
cracsgrl
on 3/1/12 1:29 am
 Here is a link I found for you that might help or at least put you into some contact with others who had Medicare cover theirs http://www.obesityhelp.com/forums/VSG/4288196/Medicare-DOES- cover-VSG-under-quotsomequot-privatley/

    
grisaille
on 3/1/12 2:42 am - NC
Thanks - will look into it
            
HW 369  SW 369 GW 199
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