kerrieh28

Hello my name is Kerrie and have been reading TT forums for awhile, maybe posted a few times. I was wanting to know if anyone had any luck with medicaid and what do you go through and was anyone denied?
thanks

poet_kelly

I have both Medicare and Medicaid. Medicare is my primary, so they paid for like 80% of my surgery, I think. Medicaid paid the rest. I had no problems getting approval. I had trouble finding a surgeon that took Medicare and Medicaid, though. I ended up having to go to one three hours from my house because the doctors near me all didn't take it. My surgeon said it was very easy to get Medicare to pay for WLS. He said they do not require a six month diet or most of the other stuff so many other insurance companies do. I know they did not require I meet with a dietician or have a psych eval, for instance, but I had to do those things anyway because my surgeon required them. I'm not sure what the requirements are for must Medicaid, though.

Kelly

__________________
RNY 11/4/08

surgery/current/goal
270/147/130

kerrieh28

so far i haven't had any troubles with it, knock on wood. They should be submitting my paper work next month, that will be the end of my sixth month wait time. I'm just getting nervous.

Layla

traditional TX Medicaid will pay for either Lap band or RnY, I do not know where you are but, in DFW Dr. Idhe or Ihde in Arlington TX does it for medicaid.

Layla

For those of us on SSI we do NOT get medicare. Medicare and Medicaid are totally DIFFERENT!!!! I am high risk and the only surgery that fits my medical critera is the VGS or VSG, Yet no one will do one with out $$$CASH$$$. If you give them, the code 43659 they laugh at you. University of Texas Southwestren Medcal Center Dallas, told me to go home and die. I was very devastated and hurt.

The only way to get the RnYis to go on traditional medicaid which only pays for three precriptions per month. Which 16 daily precriptions do I give up???
?????????????????????????? granted many may be eliminated [B]EVENTUALLY[B]BUT IN THE MEAN TIME?????????
I would like to know of any state that will pay for a VERTICAL SLEEVE GASRECTOMY ... I WILL MOVE THERE!!!!!
MEDICARE IS NOT THE SAME IT DOES NOT HAVE THE SAME RULES AND ONE HAS NOTHING TO DO WITH THE OTHER!!!!!

Please contact me at: laylatnt@gmail.com

Layla

What is the relationship between SSI and Medicaid?

Question
What is the relationship between SSI and Medicaid?

Answer
Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. It covers children, the aged, blind, and/or disabled and other people who are eligible to receive federally assisted income maintenance payments.

Thirty-two states and the District of Columbia provide Medicaid eligibility to people eligible for Supplemental Security Income (SSI ) benefits. In these States, the SSI application is also the Medicaid application. Medicaid eligibility starts the same months as SSI eligibility.

The following jurisdictions use the same rules to decide eligibility for Medicaid as SSA uses for SSI, but require the filing of a separate application: Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, Northern Mariana Islands.

The following States use their own eligibility rules for Medicaid, which are different from SSA's SSI rules. In these States a separate application for Medicaid must be filed: Connecticut, Hawaii, Illinois, Indiana, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, Virginia. For more information, please see: Medicaid Information and Spotlight on Continued Medicaid Eligibility for People Who Work (Section 1619(b)).

poet_kelly

Layla, are you on SSI? If so, can you not get Medicare? I thought anyone who was declared disabled by Social Security could get Medicare after two years. But I could be mistaken. I am disabled and I do have Medicare, but I'm on SSDI, not SSI.

I don't know if Medicare pays for the sleeve or not. They paid for my RNY. And they pay for my prescriptions. Well, I have a co-pay for them. Which is doubling in January, but the way. I'm a bit unhappy about that news.

Are you saying that Medicaid in Texas only pays for three prescriptions per month? That's ridiculous! I have Medicaid in Ohio, and they don't pay for any prescriptions because I have Medicare now, but before I had Medicare, they paid for all my prescriptions.

Kelly

__________________
RNY 11/4/08

surgery/current/goal
270/147/130