New here
Hi everyone. After 2 years of being encouraged by my doctor I have finally decided to start looking into having WLS. Your site looks very supportive and helpful!! I am just in the begining stages, have not even picked a surgeon or been approved. I am sort of trying to figure out what to do to get started.
Also I have Employee Benefits for my primary insurance and I have Illinois medi plan for my secondary coverage. I have not a clue if either have ever covered WLS.
Any tips or info would be greatly appreciated!!
Shelli
Hi Shelli~
First of all I would like to add my welcome here to you! I hope that you find this site as encouraging and supportive as I have, as well as filled with friends.
Regarding your insurance, I'd check your plan benefits books to see if WLS is covered and I would also call the number on the back of your insurance card and ask them if your specific plan covers WLS, since plans vary by company. If you're not opposed to people at work knowing, you can also check with whomever deals with the insurance plans at work, like human resources or something.
Best of luck to you in your journey, wherever it may lead you!
Hugz,
Cathy
Thanks for the welcome!! I have checked about my employee benefits insurance, I looked in the book tonight and it says it is not covered. I also have Illinois medicaid card. I checked on the Illinois dept. site and found that surgery for Morbid obestity is a covered service. It says approval is limited to cases of extreme obestity with morbid complications. Final decision per case will rest with the department.
I wonder what they consider morbid complications?? I am not on my death bed, LOL but prefer to have surg. before I am!!
I guess it is worth a shot, all they can do is say no!!
I need a referal to a surgeon who will accept Illinois medicaid.
Shelli
Welcome to the site!Im sure you will have no problem getting answers around here.IM in Zeigler my dads the Schwansman in your town.So we are close..Here i looked it up incase you didnt find Debs list.
Dr. Maillefer
Dekalb Clinic
217 Franklin Street
Dekalb, Illinois 60115
815-758-8671
Dr. Shayani In maywood.... he only does the Lap Band and he requires you to go to one support group meeting then will schedule a consult he moves pretty fast. 708-327-2899
Dr. Oliphant in Urbana he moves slower you have to call his office for a packet fill it out send it back in and you'll hear from them for an appointment in a few months I think he's currently scheduling for January/February. 217-383-3240 RNY only
The surgeons at the COMP clinic at SIU they require a $260 up front to cover things that medicaid wont ??? and then $10-20 for nutritionist appointments and support group costs too. (217) 545-COMP Open RNY only
Dr. Frederick Tiesenga in River Forest. (708) 386-1078 He just started accepting public aid. To get into the consult with him you will have to go to an informational meeting and get a packet. In the packet will be papers for you to fill out. You will need an upper GI, Gallbladder U/S(If you still have it), Psych Eval, Sleep Study (IF NEEDED), nutritionist consult ($75 OOP) You also have to write an essay explaining how YOU think the surgery is and how it is going to go. You have to explain WHY you need the surgery. (This all gets sent to the insurance company) He is now only doing 2 IPA cases a month.
There's a surgeon in Bloomington Indiana that just got Illinois Public Aid providership. His name is Dr. Bradley Ray 812-330-9962 LAP Band Only His people are GREAT!!!!
ESPECIALLY ON YOUR PSYCH EVALUTION MAKE SURE its done by a PhD or MD and MAKE SURE it says that you are being RELEASED for surgery and that they feel you would be able to handle all the changes that encompass this surgery.
Well good luck hope something helped.
Thanks everyone!! First off do I call the surgeons or does my pcp? She has never handled (my pcp) a referral for WLS. She said she would do anything she can to help. I am going to schedule an appt. with my pcp and talk with her about the info I have gathered and also have my physical. The documentation from this upcoming visit I am sure will be important. All of my comorbidities will have to be put down in writing. They have been, but are scattered through out my chart. I also have been to see a back surgeon for my bulging discs, his recomendation at that time was weight loss and exercise to strengthen the muscles to help hold the discs in. One of the discs comes out and presses on a nerve occasionally causing excrutiating pain. So far I lost about 40 pounds and gained that back plus some doing the Adkins diet.
The Schwans person I have is lady!! How far away are you from me?
Also if I go to the consults ect... and public aid denies me for surg. do they still pay for the consult??
So many questions!! I am going to drive you all crazy!!
Shelli
When you deside which doc your going to go with you call them up and ask them to send you a packet.fill it out and what you need from your PCP is a referal to see that doc and all the info of problems you have had and weight documents the PCP might have or any Doc that you have went too
..Well it says your from Hamilton as in Hamilton county?Anywhere near Benton?
You know thats a good question ,If they denie you for the surgery they would still for the pay for the consultation.Thats ok im already thereAsk away.If i can help il answerIf not we have some OLD pro's in here They are going to kill me now