Recent Posts
on 4/15/15 3:36 am - Margate, FL
The way share of cost (SOC) works is this: once you have exceeded your SOC for the month you are on straight Medicaid. This is what I did .......I went to the ER with a minor complaint at the beginning of the month . A few days later I got the charges for that visit & faxed it to Medicaid to prove I had met my SOC. After that I was on straight Medicaid for the rest of the month. Here's a plan: Find a Surgeon that accepts straight Medicaid. Make a appointment with them. If the appointment is May 15 you should go to ER May 1st. That gives you 14 days to get the system updated to your Medicaid. While at the surgeon as which tests needs to be done for authorization. Get as many of those tests done as possible that month bcuz it's covered by Medicaid. Medicaid also requires 6 months of visits with your weigh ins & weight discussed with the Dr. If you've been under a physician's care & can get those records it counts toward your needed 6 months. Also most surgeons want you to go to their seminar before you can schedule an appointment. So be sure to do that as well. If you have any more questions I'm here .hope this has helped you
DS: 5/28/14
HW: 310
SW: 302
CW: 160 ( 1 year post-op) 160 lbs gone
on 4/14/15 10:54 pm - Margate, FL
What is your share of cost amount?
DS: 5/28/14
HW: 310
SW: 302
CW: 160 ( 1 year post-op) 160 lbs gone
I'm going to butt in on this conversation and ask for help. I'm on the medically needy SOC Florida, and I'm in the same boat as someone else, my regular insurance that I pay for won't cover it. Where should I go to? I can't even find a list of surgeons. And how does that work? Does the surgeon bill me or Medicaid? I think that's my main hangup, I don't have a Medicaid number anymore since my post-pregnancy Medicaid is over with, no card or anything. I don't even know where to start at. I've called the surgeon's offices and they say that they don't accept share of cost Medicaid, even some big hospitals that boast taking Medicaid like U of FL Bariatrics. I called the Medicaid office here locally and was told that I had to find a PCP that took Medicaid for them to even start the process of approving a BS. I went to one and he agreed it would be the best route for me, but when I was refused from every surgeon I contacted, I started to get disheartened. Sacred Heart gave me two names and addresses, one in Miami and one in Ocala. Please help. I don't even know where to start or where I should go. I don't mind paying the dr's visits out of pocket or travel expenses, but I simply cannot afford the surgery in cash at this time.
on 4/5/15 11:05 pm - Margate, FL
Have you started the process yet?
DS: 5/28/14
HW: 310
SW: 302
CW: 160 ( 1 year post-op) 160 lbs gone
Just had a VBG to RNY done on 3-3-2015. Operation went fine but had complication with heart. Spent 4 days in ICU. I am home now doing well. Dr Murr was fantastic. TGH gave great care.
I had the band placed 8 years ago and lost a considerable amount of weight. Never got to goal because I got pregnant with my son. Never could get back on track and my band stopped working. It is filled to where they can't even pu****er in anymore, yet I can eat almost anything after 10am. But I still get reflux and have terrible body pain with my weight coming back on. I also have pain whenever I eat or drink anything and when I lay on my side. I want this band out and I want to get the bypass surgery I originally wanted but was talked out of.
I am looking to have my revision done at Tampa General with Dr. Murr. I have BCBS of Texas and have already checked to see what is covered. I have to pay up to 3k of all costs, then the rest is covered by my insurance. The only requirements I need for approval are a note from a psych, to be over 40 BMI (I'm 56 BMI) and the surgical facility needs to be a "center of excellence" which TGH is. So I am clear on all that.
Here are my questions:
1. If you have gone through TGH did you have to pay program fees, and did these get covered by insurance or did they count towards your copay/deductible amount with insurance? How much was your program fee?
2. They require a WLS seminar, and a WLS pre-op group meeting. Can I start the insurance approval process before the group meeting? I really want to get surgery done the latter part of May, and it can take approx 30 days to get back approval, but the pre-op group meeting I can attend is only available May 4th and my seminar is not available till April 20. I just have a lot of things going on this summer and I need to be on the path to recovery asap.
3. How long did you stay in the hospital? Their WLS brochure online was done in 2009 and states that you have to stay in the hospital for 3 to 5 days. But I am reading surgery stories of people staying in the hospital for only 1 or 2 days.
4. Anyone have revision with Dr. Murr? How does he feel about it?
5. Just overall, what are the things you love and hate about TGH and WLS there?
Hi Kdiva, I am also under medically needy with medicaid, I desperately need this surgery but I don't even know where to start. Any help would be appreciated
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My WeightLoss Journey Continues: Next Phase - Body Contouring! I met with my latest New Doctor "A Plastic Surgeon: Christopher Newman, D.O." After a thorough discussion and examination & pictures taken.
It was onto what Insurance (He accepts many but most importantly mine Humana. The only Plastic Surgeon that I know of in the Tampa Bay area who will accept what Insurance companies pay rather that setting his own fees.)
I will be receiving a Panniculectomy: the apron of skin& remaining fat that happen when a person losses a tremendous amount of weight . As myself having lost 450lbs. Dr. Newman is estimating this will be about 35-40 more pounds.
This removal WILL make my life & movementability much easier.
I feel very good about this procedure and Dr. Newman. As I did about Dr. Rehnke and my Gastric Bypass. Now I wait to hear from Humana for their approval.
If you've lost most or all of the weight you've hoped for call and make an appointment. He accepts many insurance plans. As he testifies he CARES it's not all about the money.
http://www.floridaprs.com/
