New protocol for submitting to IL Medicaid??

 Hi everyone,

I talked to the Insurance Specialist at my surgeon's office today, and she said that starting in September that Medicaid no longer was pre approving WLS.  She said that their office makes sure you meet the Medicaid requirements, then you have the surgery.  After surgery, they submit your file to get payment from Medicaid.  Has any one heard this???

So now I'm worried (a.k.a. FREAKING OUT!).  Do you think this means that if I meet the requirements then they will pay, or am I gambling that they may or may not cover my surgery?  I've been at this for so long, attending classes, etc., but if I don't have a guarantee of payment, I don't think I should have the surgery.  Uggh!  Does any one have any insight?

Wow, I have not heard of this! I was pre-approved in June within 10 days of being submitted. If they have indeed changed it that sucks. However, the State of Illinois is in very bad deficit and this surgery is very expensive. Especially if you end up with long-term complications like me. I have to have a repeat surgery done every two weeks for the next 3 months due to my WLS complication. I'm sure my RNY has cost Illinois over $50,000 by now, with everything that's happened to me. In and out of the hospital, ambulance rides, ER visits, repeat surgery....it all adds up. 

My MAP Grant for college was also screwed with in August because the state is broke.

I'm so sorry to hear this, I wish you the best of luck!

~Heather

 Thanks for responding.  I hope to talk to their office more about this next week.  I don't want to end up with a huge hospital bill that I wasn't expecting.  The deficit is scary, so it makes me question the probability of getting them to cover my surgery.

I'm sorry to hear about your complications.  I hope everything works out for you.

sorry to hear about your complications. i went to uic on taylor street about ten days ago and they never mention that to me.the only thing they said was medicaid dont cover the lapband but the sleeve, bypass and revisions they do.

 Thanks for responding.  I hadn't heard anything about it either until about a week ago.  I hope I get them to cover it though either way.  Good luck to you.