Medicare persons over 61 HELP

Please persons over 61 from the Cinti Ohio area that are on Medicare. 

I am scheduled for surgery in 2 weeks and I read that Medicare in southern ohio  does not cover the sleeve if you are over 61.  Please is there anyone out there that has gotten the sleeve recently and in this area that Medicare covered it?

I also have BCBS but they will not pre-cert me because Medicare is primary.  Which means if medicare does not pay, they will not pay and the whole bill will be mine.

Please anyone out there help.

Your best information is going to be from medicare, give them a call and see what they say.

I am in NC but I did a lot of research - Medicare DOES cover (nationally) the Lap-Band & RNY IF you are a qualified candidate.  IF in a case such as mine the surgeon refuses to operate due to major medical reasons then IF the surgeon fills out the re-approval correctly you CAN be approved as I was for the VSG...But other than that Medicare DOES NOT cover the VSG nationally as of 2012-2013 right now.

There is a proposal on their agenda and if you want the LONG wordy agenda I can provide you with the sites. One is 47 pages, one is 53 pages, ones is 24 pages, etc...there is proof it is safer, so a committee is doing a 1 year study on it.

They are hoping to have it approved and available to Medicare recipients in March 2013. It goes back to the original committee then for a vote. 

Like I said, I have researched this thoroughly!

Ann

I'm a little behind on reading the post.  I am 59 and I have anthem senior advantage. I heard that Medicare approved the sleeve on Oct 31. So I called 2 days ago. I gave her my card number and the code 43775. she said yes it is an approved surgery. Having it done at Jewish Hospital in Cincinnati

I called medicare on Thursday and gave them the cp code of 43775 just like you and they said they did not cover it. 

What is Medicare anthem senior advantage?    I am also older than you 65.  Another person posted a rejection  at one of the other hospitals in Cinti and had to put in for the by pass surgery.  Don't know all the ins and outs but it is surely different for different people.

H, I don't now about the age thing.  Medicare Anthem senior advantage is the carrier I get my Medicare through. it is a plan  through BCBS

Sounds like a MedAdvantage plan which replaces Medicare as your primary insurance.  I have it thru Regence BSBC and its great.  I only paid $125 copay for my surgeries.  Medadvantage plans have to cover whatever Medicare covers on a national level.  My hubby is on a higher deductible plan that cost $99 per month.  Might be time to sign up.