Medicare - Medically Supervised Weight Loss

[Lifepm]

Hi,

I’m new to all of this.

My doctor will send me to the Bariatric Department based on my weight and a co-morbidity health condition.

I’m concerned about Medicare’s medically supervised weight loss program requirement. Actually, it states “Documented participation in medically supervised weight loss program”. I haven’t been in a program since I was in my late teens. I have no documentation of the program.

If I’m put on a program now, I might fall before the BMI requirement. Taking off weight could happen, however, I have difficulty keeping it off in the long run. Also, I’d hate to have to push off the surgery do to this.

Obviously, I’m afraid of not qualifying for a program.

Any person experience or suggestions?

Thank you!

 

[KarenWV]

Hi,

I’m new to all of this.

My doctor will send me to the Bariatric Department based on my weight and a co-morbidity health condition.

I’m concerned about Medicare’s medically supervised weight loss program requirement. Actually, it states “Documented participation in medically supervised weight loss program”. I haven’t been in a program since I was in my late teens. I have no documentation of the program.

If I’m put on a program now, I might fall before the BMI requirement. Taking off weight could happen, however, I have difficulty keeping it off in the long run. Also, I’d hate to have to push off the surgery do to this.

Obviously, I’m afraid of not qualifying for a program.

Any person experience or suggestions?

Thank you!

It took me a total of 10 months from 1st dr visit to undergoing surgery. One of the longest parts of the process was 6 monthly visits to my pcp as part of a supervised weight loss program. This involved the completion of flowsheets documenting my efforts to follow a healthy diet and exercise program. This was just a hoop to jump through to get approval for WLS, that showed my willingness to cooperate in weight management efforts, in my opinion. My bariatric team actually didn't want me to lose much weight bc my bmi starting level was not high enough to allow me to lose much and drop below the insurance requirement.

Good luck and please keep in touch if you have any questions, concerns, suggestions, etc.

 

[MANDY2910]

I am on Medicare and they didn’t require the 6 months. Just 6 months worth of documentation that I was obese and my doctor talked to me about it. As much as I go to the doctor that wasn’t hard. Anyway I hope it’s the same for you and insurance doesn’t need it. Don’t be surprised however if your surgeon does.