Recent Posts
hello, did anyone ever get anything going? I am iin New Port Richey and would totally love a local group. I have s hard time motivating myself to drive to Tampa general.
Hi, I had rny with Dr Murr in 2012, I was in hospital three days. I had anthem BC/BS, I just had to pay my co-pays and jump thru the hoops. Dr Murr and his staff are great. My co-pays did not count towards my yearly deductible. I reached my goal and then some at 15 months out and have been maintaining since. Good luck, TGH was a good choice for me.
Um I still qualify for it I guess idk. Yes, they cover the sleeve, by pass and band. ..just depends on your managed care hmo I'm guessing. Not sure why they would give share of cost with a 0 share of cost. ..which is straight medicaid. You should apply for you.
hey. How did it go? Have you started losing weight yet? Some doctors want to see that you are committed and that you will be successful post-op. They give you a percentage or a specific number to lose... or your Dr will be able to show your insurance company that you failed losing weight even under a doctor's supervision. That can be a good thing. I'm stuck at about 10-11 lbs lost. I need to be more disciplined. Can u let me know what's working for you?
Sleeved: 12/17/15
HW: 284 lbs. SW: 266 lbs.
CW: 251 lbs. GW: 140 lbs.
Hold up, how do you have Medicaid? Right after the Affordable Care Act started my medicaid was taken away and they gave me share of cost. Luckily my share of cost was $0...
Now I have full benefits through my job but I can barely afford going to the doctor, seeing specialists, and getting all of the tests done that I need. My kids have it but I didn't apply for me. Ps-medicaid covers the sleeve??
Sleeved: 12/17/15
HW: 284 lbs. SW: 266 lbs.
CW: 251 lbs. GW: 140 lbs.
on 6/29/15 2:33 pm - Margate, FL
To answer your questions:
1. My visit to the ER was totally paid for through Medicaid. I only saw the bill bcuz I needed to fax it to Medicaid to prove I had met my SOC for that month. So there will be absolutely no out of pocket expenses for you to pay.
2. I've only needed the 1 visit to the ER for approval of my surgery. Reason being I was previously covered through Medicaid on Humana. However when my surgeon submitted for approval I was told he was out of network for Humana. So I switched from Medicaid Humana to Straight Medicaid.
3. By the time I was on the SOC I already had all pre-op testing done. What I'd suggest for you is to find out which Dr's accept the SOC for the necessary pre-op clearances and schedule them all in the same month. To be safe make them middle of the month so that you can be sure you've had time to meet the SOC & submit it to Medicaid. Your surgeon office should be able to help you find where you can go. Also your surgeon office visit mat not be that much out of pocket. I only saw my surgeon 2x before surgery. 1st time was to meet & discuss my options. 2nd was when he did my endoscopy for the pre-op.
Clearances that I needed:
Psyche
Cardiologist
Endoscopy
Letter of medical necessity from PCP
6 months of supervised visits from PCP
Who is your surgeon? Have you started the process?
DS: 5/28/14
HW: 310
SW: 302
CW: 160 ( 1 year post-op) 160 lbs gone
Hello Kdiva:
I am trying to get my bariatric surgery thru SOC. I understood everything you explained before, but I would like to know if the expenses of the ER visit were payed by Medicaid too, or you never received any reimbursement for this expenses?
Another doubt that I have is: What kind of medically expenses are allowed to activate the Straight Medicaid? I just have to run thru ER and that's it?
The Doctor office told me that they accept SOC Medicaid but they told me that is really hard, because I have to spend each month my SOC amount which it is 1,200 until I got the approval, so it is really risky.
What do you recommend me to do. I am desperate, my back is killing me, I am so sad all the time, I can even put my sneakers properly, I feel like I am jailed in the body of someone else. But is really hard to get information about this kind of surgery and cover.
Thank yo so much for share your experience. In all my Internet Research your post are the only clear information that I found.
God blessed you!
Yes they are great and if you take your PCP the stuff that is required by your insurance you will get everything done asap I just got my Approval and surgery date yaay.
I am having surgery with Dr.Murr in August.Very nice staff and the surgeon is very well recognized.Also had the pleasure of meeting Dr Go salvo he did my endoscopy.
I go to the one at Cleveland Clinic. All are welcome even if you didn't have the surgery there.
