Medicaid & the process

Hello.  I have decided to get WLS and I live in Illinois.  I have a medicaid card for insurance and I was wondering if any one can give me some direction on how this process works with IPA.  I feel like I am running into constant brick walls.  I called St. Francis in Peoria and they will take the card, but not in my zip code!  What is up with that?  It's the same card regardless of where you live in the State.  Anyhow, if there is anyone out there who can give me some direction or has been down this road, I would really appreciate it. 

There are a few in Chicago who accept medicaid and one in Springfield. Springfield is thru what they call the comp clinic. It is RNY only and it is a 9 month process. Call them at 217-545-2667. Springfield will cost you some out of pocket cost.  Beth

Hello there and welcome to the IL board. On the top of the IL message board is a thread that was started by the OH staff asking that same question. There were a bunch of answers from IL board members to the questions. You might be able to find some helpful info there. Again welcome to the board. Hey one of us always puts up a daily roll call. You are welcome to come in and introduce yourself and stick around to get to know the rest of us. There is always someone there that can help you get info for whatever questions you might have. We have all gotten to know one and other all over the state this way. In fact there is going to be a get together on April 19th at Lucy's clubhouse. All are welcome pre and PO, families etc. Christine

Hi, I am also using medicaid and live in Illinois. I thought I wa****ting the wall too. Until I realized, after making many calls and many hours on the computer, that there is a dr in Peoria that accepts the medical card no matter where in Illinois. I also tried the others in peoria and they too told me that I was out of their area. Go figure. Anyways, here is the contact info  Dr Salimath  1-309-671-7764. He does his surgery out of methodist hospital in peoria. I have my first appt march 5th withhim.  He has done about 110 surgeries , and sounds pretty good i think. They say as soon as i get my testing done, there really isnt a wait for the surgery like chicago and st louis. They say the longets would be about 5 months. Give them a try. Since it is a weekend, try looking up methodist hospital in peoria and read up on them. Hope this helps, Tracy

Hi Tracy... Thanks for the info.  I don't know about how you feel about all of this but I feel kinda like I am alone fighting to make this happen.  Peoria is only an hour and half away for me, which would be soooo much easier for everyone.  Did you just call Dr. Salimath's office and set up the appt or did your PCP do that for you?  Kathy

I did just call them and make an appt. They say you have to sit through his seminar which lasts 3 hours long. But then he does have appts those days too, so since I told the receptionist that I was sure I wanted to go through it and i had read up on it, she went ahead and made my appt for right after the seminar. Now I just got a message from another lady that is using Dr Salimath too, and she says she just had her first appt with him 4 weeks ago, and she has all her tests done, and is waiting for her approval. She is also on medicaid. So we are right on each others heels. If you need any more info, let me know, hope this helps, thanks!!!

I also have IL medicaid and have been going through the process since September.  I have had my psych eval (paid out of pocket because it is next to IMPOSSIBLE to find a doc that will do it on the medical card), but I only paid $125 which is on the CHEAP side.  I had an appointment with a doctor out of decatur IL however he just seemed like he was nervous and didn't have confidence in his ability so I nixed him right away (Dr. Gilman) and then I made an appointment with Dr. Ayloo out of University of Chicago.  She is a lovely woman.  Her office staff has been nothing but helpful and are on the ball when it comes to insurance approvals and denials.  She requires 3 visits prior to surgery, and keep in mind, its a 4 1/2 hour trip for me, but WELL worth it.  I feel 100% comfortable with her.  She gave me all kinds of information to read up  on and was very nice and made sure my husband understood everything as well.  Before seeing her you want to be SURE that you want to do this because she does not sugar coat ANYTHING.  She makes sure you understand that you could possibly die, although its not likely, there is the chance.  She makes you diet and lose at least 10 - 15% of excess body weight before surgery to make sure your commimtment is there.  I have almost daily communication with Jennifer at the office to check status and see where I am, but now its just the waiting game from medicaid to see if I get the approval.  If you're interested, she is well worth the extra mile..... Dr. Ayloo 312-355-1578

I am the other gal using Dr. Salimath. He is great. I have had so many other surgeons and doctors tell me what a nice guy and great surgeon he is. They take medicaid for any of the procedures. He is one of the only surgeons that does the sleeve. Any day now I should be hearing back about approval and set the date. I don't think it takes long to get in for the surgery and Monica coordinated all my appts with docs who took medicaid, including the psych eval. I'll keep you all posted as to when my date is so maybe you know what to expect with time frames.  God Bless, Kelley

Hi Kelly... That is great to hear.  I have my first appt with him on the 12th of March and I too thought Monica was so nice and helpful.  Are you going to have the sleeve procedure done?  Thanks. Kathy

Hi Kathy, Well as long as medicaid approves me for it, they just started giving approvals for the sleeve, so I feel confident that is what I'll get. Of all the surgeries it really feels like the one I would be most comfortable with. I really don't want something in me that had to be adjusted, especially when insurance only covers one adjustment and then its out of pocket at 400 dollars and up!! I hope all goes well you are making a good choice with Dr. Salimath.  Kelley