Newbie Questions about Medicare or Self Pay
 

Hi All,
I just went to a Lap Band seminar tonight and found that Medicare will only pay for surgeries done at Medicare-approved facilities. The program I am interested in appears to be quite reputable but does not have the Medicare certification. The closest program that qualifies is in another city 100 miles away. However, they are not so hot on Medicare cases because of the minimal compensation they receive from it.
The sort of good news is that my local program will be accepting Medicare but not for a year.
My first question is if anyone here has had Medicare pay for their lap band and what did they have to go through?
I have a glimmer of hope that my mother may pay for the lap band so I could get it sooner. The price quoted by the program was $17k which includes a year's worth of follow-ups. How does this compare?
Thank you so much for your time.
Pennie

Hi Pennie!

I had GBP surgery but I do have Medicare so I have a bit of experience. They paid for the majority of the cost but I did have to go to a Center of Excellence and I had to use the only Dr. here in the Boise area that was approved by and took Medicare...Both of which were not approved until a year ago...2 years after I started asking around about the surgery. Now I could have had it done sooner but I would have had to go to Portland, 8 hours away! 100 miles away is not bad! ;)

I would say, stick to it...self pay or ins...it changed everything for me...it's something I would do a hundred times over!

Good luck, honey! :hug:

Angela

Yep. I was told that you just need to get the surgery done at a Centers of Excellence facility. I believe the facility has to go through an approval process of some sort.
Tasha

I was a self pay and it cost me around $16,000 for a Vertical Sleeve Gastrectomy.