Input appreciated

Hello Everyone, I asked this a while back but don't recall any responses.  There are so many things in the news these days, including shows such as "Big Medicine" but rarely do any of these mention the problems most people have obtaining coverage through their insurance. In the past eight years, I have had Humana, United Healthcare (twice), Cigna, and for the past five years, Anthem Blue Cross Blue Shield of Kentucky.  Each insurance company has had iron-clad exclusions... the current policy is the worst yet. I am 600 lbs., 6'1" and am 29 years old.  I have sleep apnea, moderate hypertension, swelling in my legs and have had a few cellulitis infections due to the swelling.  I also have at times severe joint pain in my knees and ankles and my feet hurt constantly.    I am still trying to work a full time job and persevere but I know my insurance isn't going to cover it.  My State Rep and several people in KY government are researching ways to assist me with paying for it, more of which I will document on my website that I am working on, in coming weeks. I don't think I can do this much longer.  I have thought about researching dropping down to 30 hours a week at work, which cancels my group insurance, and enables me to get KY Access... which according to what I've read, covers the surgery.  My first question, has anyone done this, or had any experience at all with KY Access insurance through the state? My second thought is to just temporarily hang it up and sign up for SSI.  With SSI, I would get MedicAid, right?  I have read that many doctors do not take MedicAid because there is a chance they don't get paid for it.   I need to know if anyone has had experiences with this route before.  If you could share your experiences with me, and maybe prefer to not share in public on the forum you can email me at [email protected]. Any help is greatly appreciated! Thanks Charles

First check with your DR to see if the would say you are disabled.  I wish you all the luck.  Also make sure you worked 5 of the last 10 years or you won't get squat.  I took time off to raise my kids and now am being penalized because I have worked 4 of the last 10.  I suffered a stroke.  I have no choice but to work.  We moved into our dream home after I went back to work.  We spent 16 years living very frugely.

Thanks everyone for your input.  THat is a big question, whether or not I can go back to full time if I were to go part time.  I make a decent wage and with the economy my employer may be very happy to cut me back a little, esp. not paying for my insurance.  Currently single adults do not pay for insurance but if I had a dependent it would be about $500 a month or so for them. I don't think I'd have a difficult time being declared disabled, mostly due to my back pain and joint pain.  If I didn't have a desk job, I would not be working. As for the work experience nuke, I have worked since I was 16, so 13 years, and have worked full time since 19 or 20.  I had one experience in 2003 where I was laid off and didn't have a job from March to October but I did have unemployment benefits and was actively seeking a job.  So who knows.  I know a local disability lawyer pretty well, I probably will save myself a lot of questions about the process by just asking him. Thanks everyone!  Any more input is greatly appreciated! Charles

Hi Charles.......  Medicaid does pay for wls, you just have to search for a surgeon who will take it as primary... good luck

Definitely check with your doctor to see if he/she would qualify you as disabled. To get SSI you actually don't have to have a 5 year employment history. For example you can NEVER work a day in your life but be deemed disabled and receive SSI and Medicaid. However if you want to get Social Security Disability you have to have a work history and with this you get Medicare. In some cases if your SS Disability isn't enough you will qualify for SSI and have both medicare and medicaid. With Medicare you will need to find a hospital that is a center of excellence because that is the only type of hospital they will pay for. Also I've heard that Medicaid is making you have a 6 month medically supervised diet history so I would start that now. More people take Medicaid for this surgery than what you would think. If you look at the top of this message board their is a post about all the surgeons who take Medicaid/Medicare in KY. I used Medicaid as my insurance and it was by far the easiest route. I didn't have to go through the BS insurance companies put you through. With your weight now I think most surgeons will have you lose some before hand to make you safer for surgery. I think a good diet to lose would be a liquid diet like Optifast it's a bit expensive but I hear it works wonders. Or you could just purchase protein powder and do shakes and a high protein dinner. Anyway I am full of answer and could write a novel to ya lol  If you need anymore help or just have questions please email me [email protected] Take Care & Good Luck! :-)

Bless your heart!  If you cut back to 30 hrs per week would you have the option of picking up hours later?  Getting medicaid would help you tremendously.  These doctors do get paid  y medicaid, they just pay at a smaller rate than most private insurance.  There are many good doctors that do indeed take medicaid. Don't give up your health is too important!  GOOD LUCK!