Slipping through the crack

Well my day has been the most worse it has been in forever.I went to the regular doctor because i've been sick come to find out that because, I have Medcaid that I'm only allowed 12 visits per year with the doctors,so I could not be seen. Then I had to call the Medicaid office and ask them what am I suppose to do ! Because the gastric bypass surgery that they pre-approved I have to go to a pre-op appointment and a follow up appointment and to my amazment the lady said well than u have to cancel it ! I already use up all of my visits because i'm a heart patient and I have to go to the doc all the time ! So I was so close but that is it no surgery for me! I can retry in January but I need to get a job so I have to look ! I always try to be a good person but this stuff always seems to happen to me !

OMG!!! I'M so sorry to hear that..That's crazy.I also have medicaid and i also had quite a few other doctor appts. this year w\o knowing about the limit of visits you are allowed ..I'm so nervous now that the same thing will happen to me .How did you find this out.Did medicaid call you?Or were you at the doc's and they denied your visit?I really feel for you . hmm Doc O's office couldnt help you any?

I never heard of a limited number of visits for Medicaid patients. I work in a hospital and I see clinic charges sometimes 12 times a month for Medicaid patients. Also, post-op visits for the first 3 months are a considered a part of the surgical procedure so the doctor shouldn't be billing Medicaid for them.

Thank u for writing and guess what Dr.O's office came through for me Rhonda called Medicaid and talk to some lady and she said that I could have my surgery and that my pre-op,surgery and follow up visits has nothing to do with my regular visits to the doctor but the only problem is that i'm still sick and I can go to the charitty hospital that is my only way to get a doctor to see me so I guess I will .Thanks for all ur help!

Wooohoooo Awesome Michelle .Great news,I'm so glad to hear that .I figured the doctor's off.would and could do something.ongrats!!!

Hey....Medicaid does allow only 12 visits per year total. BUT, your PCP's office can medicaid and get an extension, it sounds like that is what Rhonda did. It shouldn't stop you from having surgery though. Because your appts with Dr. O after surgery is post op which is free anyway. And your pre-surgery labs/test is not considered a doctors appt, which means its not part of the 12 visits. They put limits like that because some people take advantage of going to the doctor when they really don't need to, but they do just because they have Medicaid. I've worked in the medical billing/insurance/collections field for the past 7 years, so I know a little of how it goes. Keep us posted! Christie

Thank u for the info I will have to talk to my regular pcp about it because my heart doctor and i have to at least go 3 times a year if not more and I can't miss those visits so that accounts for at least 3 of not more and just being regulary sick is not helpful if I can't go to the doctor!