Medicare and Medicaid

I have a appointment June 28 to try to get help with the 20% Medicare does not pay. I just wanted to know for other people who have been through the process do I wait first for medicaid then file with medicare or file now with Medicare?My Dr told me he would give me a referral when I'm ready, does that go to the bariatric Dr and do they get a hold of Medicare, not sure how to proceed. Any information would be helpful I want to get this started.

Your surgeons office should submit your paperwork to medicare when your ready. They will bill medicare and then medicaid. You shouldnt have to worry about anything. Do you have a pro-op diet or any pre-op diet and exercise you have to do before surgery?

My primary doctor sent a letter of recommendation to the bariatric surgeon's office. He then, when he saw I met Medicare's requirements, performed the surgery. Then he billed Medicare and my secondary insurance. Medicare does not require a pre approval. Just call them and ask for their requirements. The BMI needed, the co morbidities, the years of weight and blood pressure etc. My primary doctor had my history and send what was needed to the surgeons office. I don't know anything about Medicade as I have AARP Plan F as my secondary and it picked up where Medicare left off. It was very easy. No insurance approval or waiting period. My surgeon did make me do 3 months in their weight management program but that was his request and not a requirement of Medicare. It was for my own education and I am glad I did it.

Medicare does not pre-approve WLS.  There is nothing for your doctor to file with them. AFTER you have surgery, they just send them the bill.

When you have Medicare and Medicaid, Medicare is your primary. The doctor bills Medicare, they pay their part, then they will bill Medicaid for the rest.

Medicare (traditional) and Medicaid both require that your surgery be done by a surgeon who is a part of Center of Excellence.  Medicare publishes their requirements for procedures, and I am pretty sure that WLS has national rules (rather than different rules for each state)  You can look the rules up on Medicare.gov.  Your surgeon's office should be very familiar with the requirements for Medicare and Medicaid, if they are a Center of Excellence.  If they are not, you will have to pick a different center that is.