MEDICAID AND MEDICARE SURGEONS LIST!

Saint Joseph East  hospital has a bariatric center of excellance in Lexington ,Ky.They accept Medicare and it covers 80%. I was told my 20% would be about $950.00.I had to pay the 1st 250 up front and could be billed the balance after surgery.The number is 1-859-967-5520.There is no 6 month diet.Medicare doesn't  require it..They send u to a seminar ,1 is free and the other one is $375.00 that can be paid in installments.                                                Hope this helps,                                                          Tina

Send in by member via email: Dr. Thomas Sonnanstine Tristate Surgical Weight Loss Center "Center of Excellence" Florence, ky 859-212-4625 ask for Kristine Schlanser, the Insurance Coordinator or Taryn Harney, RN,. the Clinical Coordinator   Thanks Brenda

Sent by member via email: I hope this Helps....   I have KY Medicaid and I had the LapBand Done this year 10/5/07 by Dr. Jorge Rodriguez in Louisville, Kentucky at  Norton Bariatric Hospital (502) 583-8303. He Accepts Both Insurance....

Hey Kathy.  How long did it take after you applied for Medicaid to approve you and what all did they require??  Oh, and someone told me Norton makes you do a 6 month diet...is this true??

Hello, I didn't go through Medicaid, I was just posting what a member sent me via my personal email address.  You may want to try and post your question here on your state board and also on the insurance forum. if you need anything else, please let me know at [email protected] Take care, Kathy

I went through Norton's and they do accept IN and KY Medicaid and Medicare.  I have Anthem Medicaid and was not required to complete any diet.

Hmmm...wonder if they just require the diet for lapband and not for bypass??  Btw, what exactly is Anthem Medicaid??

In Indiana there are 3 types of Medicaid: Anthem, MdWise and MCH. It is Mediacid, but just provided through Anthem Blue Cross/Blue Shield.  It is by far the best of the 3.  You get an Anthem Insurance Card, handbook, etc... Any problems and you go through Anthem  customer service, not the state.

Anywho, Had I had one of the other 2, I would have been required to complete the 6 month supervised diet.  It is the Insurance Companies that may or may not require this diet, not the hospital.  That being said, If your BMI is extremely high (60 or higher) some surgeons will require weight loss prior to surgery. I am friends with many people with KY Medicaid/Passport that are having or have had the LapBand or RNY Bypass, and each and every one of them have had to complete the 6 month supervised diet.  In one instance, my good friend was denied after completing because her PCP had neglected to take down her vitals in her 5th month.  She had to complete another 3 month diet.

Hope this helps.

SO how do you go about getting the Anthem versus the other 2.  Oh, and how long did it take for you to get approved??

I just specified that one as my choice.  Not sure if there is anything more involved, however I am aware that there is only a certain percentage that can get Anthem and once it is full you get one of the others.  I am thinking that luck was involved as well. lol As for my approval, well let's put it this way.  I was not even aware that my info had had been submitted when the approval came through.  I had just came home from completing my pulmo tests and my approval with surgery date and pre-op blood work dates was in the mail. (see my post under "CAN THIS BE REAL") Surgery 6-2, pre-op blood and labs 5-21. So since my paperwork was submitted without all required testing, I would have to say that my approval was LICKETY SPLIT!!! In my Anthem handbook, under what is covered, it clearly states "BARIATRIC SURGERY", however, I have only had this insurance since 12-07 and had not been to a doc in years, so I had no medical records to speak of.  I attended the Seminar at the end of January, had my meeting at the Bariatric center at Norton's with the psych and Nutritionist in February, met my Surgeon for the first time on March 10, and they set up the Cardio and Pulmonary work-ups.  Saw the Cardiologist on 4-7, and received my surgery date on 4-24 (It was mailed on 4-21(a Monday) so I am assuming was submitted the week before).  I also am considered a "lightweight" as my BMI is 41.  Any more questions please feel free to ask.