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  1. #1
    Gastric Sleeve Member
    I have not had a gastric sleeve.
    Name
    Grannyfox
    Join Date
    Feb 2013
    Last Activity
    02-18-2013 04:24 PM
    Location
    Southern Indiana but willing to go out of state for approved surgery
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    1
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    Unhappy Seeking info from medicare approved gastric sleeve members.

    Anyone had medicare approved gastric sleeve? And where did you get it done/state?
    I've been searching for a state that will approve medicare for the gastric sleeve. Last years decision limited medicare approval to regional contractors decision only. Indiana's group of bariatric surgeons are fighting to get approval, but it hasn't happened yet. I need this surgery. I am way over the minimum BMI, and have multiple medical conditions as required. And I have my doctors letter stating I need this procedure. If I would say okay to a roux en y, they would approve it immediately. I don't need that procedure. I need the gastric sleeve, and I refuse to submit myself to more risks and a more complex surgery than I need. So I'm starting this thread in hopes anyone out there who is on Medicare (not Medicaid) will speak up and tell your story. Or perhaps others out there like me who are waiting to get this approved, would like to voice their frustrations. I've been doing research and attending seminars since last Dec. Beginning to feel like when it is finally done commonplace it will be too late for me. By the way I'm a new member and this is my first post.

  2. Gastric Sleeve Surgery With Weight Loss Agents
  3. #2
    Gastric Sleeve Member Debi Lee's Avatar
    I have had a gastric sleeve.
    Surgery date
    02/13/2013
    Surgeon
    Arun Rao
    Join Date
    Feb 2013
    Last Activity
    10-06-2013 08:40 AM
    Posts
    9
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    Default Re: Seeking info from medicare approved gastric sleeve members.

    Grannyfox, I am on Medicare, live in Florida, and had my sleeve surgery on 2/13, just 5 days out!! Medicare will require a 3 month approved and monitored diet by your PCP. Also, I believe any Centers for Excellence hospital will do the surgery, as that too is a requirement of Medicare. Just look it up and see what hospitals are a Center for Excellence hospital. It took me 5 months of visiting a psychiatrist, cardiologist, the 3 month approved and monitored diet, nutritionist. Your surgeon or Medicare may require you to be on a liquid diet for a few weeks to lose some weight before having the surgery. The hospital's bariatric center can give you all of this information.
    Good luck Grannyfox. I feel blessed I had no problems after surgery. I kept waiting for nausea and pain, but had absolutely none. No gas pains, no incision pain, nothing!!! My surgeon i amazing!! 5 days out I've lost 6.8 lbs!!!


  4. #3
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Surgery date
    11/04/2013
    Surgeon
    Dr. Hoehn
    Join Date
    May 2013
    Last Activity
    08-03-2017 07:22 PM
    Location
    MO
    Posts
    471
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    Was Thanked 120 Times in 108 Posts
    Said "Welcome to Gastric Sleeve" 3 Times
    Blog Entries
    85

    Default Re: Seeking info from medicare approved gastric sleeve members.

    Hi Granny, I don't have medicare exactly, I choose one of the Medicare alternatives so I got more benefits, I went through Humana. I'm on the Humana Gold Plus (HMO) plan. Their number is 1-800-457-4708. That is in MIssouri, not too far from you, but the actual hospital would be Shawnee Mission Hospital in Kansas just over the border here. They pay for the whole surgery, however, there are additional costs they won't pay in full so there still is the initial 250 registration at the hospital and things like x rays and such that you will need. They might pay 80% or so. Check it out, it might work for you. Good luck!


  5. #4
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Surgery date
    07/30/2013
    Surgeon
    Dr. Michael Perez
    Join Date
    Aug 2013
    Last Activity
    10-17-2015 04:33 PM
    Posts
    17
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    Default Re: Seeking info from medicare approved gastric sleeve members.


    Hi Granny..

    I am a first time Granny myself, 18 mos old. I am also on Medicare, United Health Advantage PPO. I live outside Fort Lauderdale, FL and Medicare finally approved down here in June,2013. My surgery was approved in early July and surgery was performed on July 30, 2013. I had alot of time to prepare for my vsg. The poster above said it best. Saw the psychiatrist, saw PCP for 3 mos required, no nutritionist altho they can tell by the BMI we don't eat well.

    I noted your post in February. I hope you have had your sleeve by now. Good Luck and feel good.

    alese inFL



  6. #5
    Gastric Sleeve Member KayGee88's Avatar
    I have had a gastric sleeve.
    Name
    Carol
    Surgery date
    05/18/2015
    Surgeon
    Dr. Dunkle-Blatter
    Join Date
    Jul 2014
    Last Activity
    05-26-2018 09:56 PM
    Location
    Lima, Ohio
    Posts
    80
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    Default Re: Seeking info from medicare approved gastric sleeve members.

    Hi, I'm on Medicare in Ohio. I had to have 6 mths of FMD monitored program. This is a new program but the dr was recruited from Ky. She says there won't be a problem. Just have to jump through all their hoops.



  7. Gastric Sleeve Surgery With Weight Loss Agents
  8. #6
    Gastric Sleeve Member Damasyn's Avatar
    I have had a gastric sleeve.
    Surgery date
    11/04/2014
    Surgeon
    Dr Andrew Bright
    Join Date
    Oct 2014
    Last Activity
    12-29-2015 02:20 AM
    Location
    Washington State
    Posts
    229
    Said "Thanks" 57 Times
    Was Thanked 68 Times in 55 Posts
    Said "Welcome to Gastric Sleeve" 5 Times
    Blog Entries
    11

    Default Re: Seeking info from medicare approved gastric sleeve members.

    Washington state here on medicare. Got approval immediately and scheduled for surgery in 2 months..
    Honk if you want to see my finger !!

  9. #7
    Gastric Sleeve Member Aquajog's Avatar
    I have had a gastric sleeve.
    Surgery date
    02/07/2014
    Surgeon
    Dr.Kim Celebration,Fl. 2/7
    Join Date
    Jan 2014
    Last Activity
    05-11-2016 10:36 AM
    Location
    Florida
    Posts
    1,421
    Said "Thanks" 57 Times
    Was Thanked 275 Times in 247 Posts
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    Default Re: Seeking info from medicare approved gastric sleeve members.

    Central Florida.. Medicare did pay for my surgery but I was told that they did not have a "pre approval "
    So did did not really know until after surgery if they would pay. All my pre surgery requirements were from my secondary insurance and the doctor .
    01/2013 information group 225. ,ht 5' 5". BMI. 37.5 ,01/30 /2014. Start pre op diet 218 lbs 2/7 .. Surgery. ..214. ..2/14...204. 03/1..206 ??.. March 6 (4 week check up 202lb. March. 8.. First goal . 199.4. BMI. 33.1. April1. .192.5. May 7. 188.6
    Jun 1. 178. BMI. 29.2. .reached a Goal.. No longer obese!!!? 7-01. ..174 , 08/1,..1965.. 08/7......14 months. 149...a normal BMI ...

  10. #8
    Gastric Sleeve Member DBarringer58's Avatar
    I have had a gastric sleeve.
    Name
    Debbie Barringer
    Surgery date
    01/27/2016
    Surgeon
    Dr Baumon
    Join Date
    Sep 2015
    Last Activity
    01-07-2017 11:37 AM
    Location
    Concord, NC
    Posts
    85
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    Was Thanked 21 Times in 19 Posts
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    Default Re: Seeking info from medicare approved gastric sleeve members.

    I to am on medicare( not medicaide) and have BCBS of FL. From my husband. I live in NC. This is what I am worried about. My husband insurance I have gotten 2 different answers. One yes and one no. Now I am worried about Medicare. His ins. Is primary and my is secondary. I have read several articles where Medicare will approv as of 2013. Then I have read it is a case by case decision . Does anyone know about NC. Or where I can look. I have several health issues Very high HBP , cholesterol problems and osteoarthritis and RA among others. Any advice would be helpful. I am. In the process of doing everything. All my Drs. Are on board. Good luck to everyone! Thanks
    High weight 246
    Sleeve weight 224
    cw eight 193
    Sleeve date 1/27/2015

    Thank you,
    Debbie Barringer










  11. #9
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Surgery date
    11/04/2013
    Surgeon
    Dr. Hoehn
    Join Date
    May 2013
    Last Activity
    08-03-2017 07:22 PM
    Location
    MO
    Posts
    471
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    Was Thanked 120 Times in 108 Posts
    Said "Welcome to Gastric Sleeve" 3 Times
    Blog Entries
    85

    Default Re: Seeking info from medicare approved gastric sleeve members.

    I would guess that it is the same as all states, contact them, they have a few pages of information they can email you on it and you can see if you qualify, good luck.


  12. #10
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Surgery date
    07/30/2013
    Surgeon
    Dr. Michael Perez
    Join Date
    Aug 2013
    Last Activity
    10-17-2015 04:33 PM
    Posts
    17
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    Default Re: Seeking info from medicare approved gastric sleeve members.


    Hi D..
    I just noticed your recent Medicare question and also noted your surgery date is soon....So were you approved and having the procedure?
    I don't know how to answer your question since your the secondary on your husband's plan out of FL. I live in FL and am on Medicare so when the procedure for the sleeve became available, I was right on it. The procedure went smoothly and now have lost all the weight I wanted. I've gained about 10 lbs but for my age (72 yo) I looked so drawn. I am 5'4.5" from 5'7" in my prime ! ha, and went down to 125 lbs.

    I wish you well and enjoy your new YOU!!
    alese



  13. #11
    Gastric Sleeve Member DBarringer58's Avatar
    I have had a gastric sleeve.
    Name
    Debbie Barringer
    Surgery date
    01/27/2016
    Surgeon
    Dr Baumon
    Join Date
    Sep 2015
    Last Activity
    01-07-2017 11:37 AM
    Location
    Concord, NC
    Posts
    85
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    Was Thanked 21 Times in 19 Posts
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    Default Re: Seeking info from medicare approved gastric sleeve members.

    Thank you. But no I haven't had it yet I just pre filled the date. I have just started the process. I have my psych evaluation tomorrow and I see the surgeon on Fri. I guess he will tell me what else has to be done. I do have an apt with the nut. On the 26th. And I have been on a supervised diet for 6 mos but haven't lost a lot. Congrats on your weigh loss. I just don't know what to expect from Medicare. I have a lot of health issues. Thanks for responding.
    High weight 246
    Sleeve weight 224
    cw eight 193
    Sleeve date 1/27/2015

    Thank you,
    Debbie Barringer










  14. #12
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Surgery date
    07/30/2013
    Surgeon
    Dr. Michael Perez
    Join Date
    Aug 2013
    Last Activity
    10-17-2015 04:33 PM
    Posts
    17
    Said "Thanks" 0 Times
    Was Thanked 0 Times in 0 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: Seeking info from medicare approved gastric sleeve members.

    Hi D

    Darn, I just went to verify your age and bam my reply is gone....Not going to rewrite everything, but I did notice you mentioned YOUR on Medicare now? If not, maybe you should apply with your extensive and debilitating health issues! I know the sleeve will be your answer, hopefully for some of your health issues.

    When I sent the reply to your post I noticed your age of 58 yo...or assuming that. Anyway, how lucky you are to have this procedure now where your skin will have elasticity, you will look much younger and most of all will feel so good and have alot of confidence in yourself...

    I am older but feel and look terrific for my age of 72 yo. I wish I knew how to put my photo on here.. I have severe back issues that didn't go away. Damaged from all the wt I carried on it. However, I have an orthopedic dr. who takes care of me...I should look at my profile, as I had a pancreas/kidney transplant (2003) due to kidney failure from Diabetes....I am visually impaired so cannot drive and depend on my husband....Thank goodness for him!--Married 46 yrs. I've been on disability since my visual issues...around 10 yrs before SS.

    I don't know if my former reply will show up, however, I will send this one.

    Good luck and keep me posted...you can PM me too.


    TTYL
    alese



  15. #13
    Gastric Sleeve Member DBarringer58's Avatar
    I have had a gastric sleeve.
    Name
    Debbie Barringer
    Surgery date
    01/27/2016
    Surgeon
    Dr Baumon
    Join Date
    Sep 2015
    Last Activity
    01-07-2017 11:37 AM
    Location
    Concord, NC
    Posts
    85
    Said "Thanks" 0 Times
    Was Thanked 21 Times in 19 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: Seeking info from medicare approved gastric sleeve members.

    Thank you. I will be 57 on Sundday. I have BCBS of Fl ( on my husband policy but don't know if they will approve). I have Medicare for my secondary insurance and hoping it will not be a problem. I have my First apt with the surgeon in the morning. I have already had my psych evaluation and I see the Nut on the 26th. I have been on a diet since Feb and only lost 20#s. I am just worried Medicare will turn me down even though I have all of the health issues. The psych said I should have a problem but I guess everyone worries. I am so proud of you doing this and you are a inspiration to me. Was it hard? How did you do during the surgery? Best of luck to you and prayers that your back gets better . I don't know how to pm you or I would. You can me. Thanks!
    High weight 246
    Sleeve weight 224
    cw eight 193
    Sleeve date 1/27/2015

    Thank you,
    Debbie Barringer










  16. #14
    Gastric Sleeve Member DBarringer58's Avatar
    I have had a gastric sleeve.
    Name
    Debbie Barringer
    Surgery date
    01/27/2016
    Surgeon
    Dr Baumon
    Join Date
    Sep 2015
    Last Activity
    01-07-2017 11:37 AM
    Location
    Concord, NC
    Posts
    85
    Said "Thanks" 0 Times
    Was Thanked 21 Times in 19 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: Seeking info from medicare approved gastric sleeve members.

    The psych said I should have no problems at all. All my Drs are on board. Sorry for the typo.
    High weight 246
    Sleeve weight 224
    cw eight 193
    Sleeve date 1/27/2015

    Thank you,
    Debbie Barringer










  17. #15
    Gastric Sleeve Member Lizzy56's Avatar
    I have had a gastric sleeve.
    Name
    Lizzy
    Surgeon
    Dr Ruby Gatschet
    Join Date
    Jul 2015
    Last Activity
    11-29-2015 04:04 PM
    Location
    West Sacramento, CA
    Posts
    16
    Said "Thanks" 14 Times
    Was Thanked 3 Times in 3 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: Seeking info from medicare approved gastric sleeve members.

    California here. 4 months pre-op education with weight loss center for training and nutritional info. Lots of good info received before surgery date.



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