Question:
WHY WON'T MEDICARE PAY FOR ME TO HAVE THE SURGERY

MY WEIGHT IS 206 AND BMI IS 40,WHY WON'T MEDICARE PAY HERE IN FAYETTEVILLE NC.    — DAISY O. (posted on November 17, 2002)

November 16, 2002
Hi there~! Great question, I do not know what did they say? on Denial? I had Medicare pay for mine in Florida Just Me's, Sister I am K
   — Just M.

November 17, 2002
Did you have your surgery already? Medicare doesnt do preapprovals. So far they have paid for all my preop testing, I dont know about the surgery yet. Also, are you more than 100lbs overweight? Do you have any comorbidities? How many supervised diets have you done? They take all that into consideration.
   — Angie L.

March 9, 2004
Medicare will only pay for the surgery if it is for treatment of other medical conditions that are being made worse by the obesity. http://www.cms.hhs.gov/manuals/06_cim/ci35.asp# and look for 35_26. This is their official policy on weight loss surgery. If you don't have any co-morbs that are being made worse by your weight, they will not pay. They also will not pay if your doctor asks for pre-approval. They don't pre-approve any medical procedure. The doc has to submit his/her bill with documentation of your co-morbs and their worsening conditions. Good luck to you, LadyT
   — Lady T.

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