Medicaid - Even those NOT on medicaid - READ!!

     OK everyone! I'm mad now!  It's time someone does something.  For about 6 months I have been comming to this sight hopping and praying that there would be some new information on Medicaid covering any weight loss surgery's. Every doctor that i have called (which is every Doctor in the STATE) says that medicaid does not pay enough, so they will not accept it for payment. Today I got off my FAT butt and I need all of your help.  I have wrote the good ole' State of Louisiana (I will post e-mail address). Well I have wrote and will keep writting the state of Louisiana until somethings changes.          The reason I am begging each and everyone to right (My son is also begging) is because it is not only my tax dollars that pays it is YOURS too!  Do each of you realize that if most of the obese people in Louisiana would have this surgery the State would actually MAKE money instead of spending it on Diabetic supplies, Depression meds., and any other problems that comes along with obesity!!!      PLEASE EVERYONE!!!!!! ban with me on this journey! We can do it! So as Louisiana TAX PAYING citizens write the e-mail addresses provided, I have done the research already, all you have to do is write. Thank You, May God Bless Each and EVERYONE! Sheree  Jimmy Guidry,M.D. or his assistant Charlayne prentiss [email protected] The above people is over health and hospitals department at the governers office. Sorry for any misspellings!

I hate to disappoint you but the sad fact is that employees of this great state of Louisiana, who have insurance, are not covered for weight loss surgery.  Civil service employees are given the option of enrolling in three different insurance plans and ALL of them have a WLS exclusion!!!  If they are not going to cover the surgery for their employees who have insurance, there is little chance they are going to allow Medicaid to pay for the surgery. There would be mutiny if they did!!!

And adding insult to injury State employees pay tax for the Medicaid receipients care and outrageous premiums for their insurance and have no wls coverage.  The state opts out of the coverage, it is not the insurance company its the  contract the state chooses.  Also they have repeatedly shut down any legislation to grant coverage in this state.. But if you pay out of pocket the state reaps the benefits of your surgery.   I am truly sorry that Medicaid recepients are not covered, but it would be most unfair to state employees if the did cover it.  So actually state employees pay twice for nothing.

I have insurance through the state of Louisiana and it has a total exclusion for anything even remotely related to weight loss of any kind.  I chose to self-pay for my surgery.  I became eligible for Medicare in December of last year and Medicare does pay for it.  Therefore, I utilized medicare for the hospital (only) portion of my surgery.  However, there is still a $992.00 deductable for that.  I recently got a call and medicare denied $10,000. of my hospital bill because I have insurance.  They are going to have to bill my insurance, get a denial letter and then re-bill medicare.  Louisianians are dying daily from Obesity Health related issue and the State of Louisiana could care less.  They have paid for two total knee replacements for my DH but won't pay for W LS to reduce/eleminate the possibility of having to spend thousands, and thousands of dollars more on health related issues that could be eliminated by having WLS.   The doctors have told him that he needs to loose at least 100 lbs, but insurance won't do anything to assist.   As soon as I get my surgery paid for, it is back to Texas for my DH to have the same surgery I had.  I love my DS.  I am down 73 lbs in six months and still loosing.  By the way, I had hypertension, type 2 diabetes, high cholesterol, and incontinence.  I had my surgery on November 5th, 2007, had to go to Texas to get it because most doctors in this state don't use Centers of Excellences; their hospital won't do surgery on an older person or the hospital they use won't accept medicare patients from other areas of the state. I had the Duodenal Switch, I am no longer on any medications at all.  Hypertension, diabetes, cholesterol and incontinence issue are all gone, never to return again.   If you are considering WLS, don't forget to check out all types of surgeries because no one surgery is right for everyone.  I chose the one that I felt was best suited for my needs and everyone should research, research and then search some more to make sure that they know exactly what they should expect from their choice of surgery.  I would give anything if the State would require that insurance companies in the State of Louisiana cover weight loss surgeries, but I really don't expect that to happen anytime soon, unless we can get enough of the politicians to stop, look and listen to the benefits that WLS would provide a multitude of citizens in this (sometimes) great state.  OK, Now I am getting off my soap box.  God bless and keep.  Toogie

Medicaid DOES pay for the surgery!!! But the problem is that they pay pennies on the dollar for the procedure.  The Doctors are the ones that are not taking madicaid, and why should they, I don't blame them. i know that I would not accept $1.00 for something that i can make $150.00 or more for. But, I will carry out this fight! so everyone can reep the benifits!  i just wish that there was more all people out there that would write a letter or something.  thanks for everything, sheree 

ditto, ditto, ditto on all the responses . . I am a retired State of Louisiana employee and had the sleeve done and they paid NOTHING (except a little of the psychiatric evaluation -- go figure!) . . . I say we are costing the insurance companies money by going to doctors, etc., because of weight-related illnesses --- why can't they see that? . . and we are paying a monthly premium. . . .so that's my two cents worth!  FAYE 

Hello Sheree, I know you feel all along, but over the years there's been plenty of research, asking and pleading going on. Before Hurricane Katrina, there were several options available for Medicaid patients and the teaching hospitals in New Orleans provided surgery for Medicaid patients. After Katrinia, the surgeons who were doing bariatric surgery in New Orleans (like Dr. Daniel Scott) moved out of state and the few who were accepting Medicaid got overwhelmed until they had to drop Medicaid patients (like wonderful Dr. William Ordonyne). I know of several doctors who did surgery on a case-by-case basis for Medicaid patients (a good friend of mine had surgery in Lake Charles), but eventually, the lack of true commitment from Medicaid made aftercare nearly impossible for the patients to afford. What I mean is if you get Lap Band surgery and can't get fills, you have been cut for nothing. The same goes for costly supplements and follow-up appointments for Sleeve and RNY patients. Unfortunately, this fight isn't just starting, but is well on it's well from a legislative standpoint. Laws will have to change this condition. The Department of Health and Hospitals does not have the power to change it, but legislators do. Last year, Sen. Sharon Weston Broome authored a study resolution to mandate the treatment of obesity for those insured in the state of Louisiana. A hearing was held and there was great turnout from patients like Dorothy Hebert, nutritionists like Jan LeBlanc and doctors Louis Martin, Thomas Lavin and Drake Bellanger. Right now, there is a bill before the Louisiana Legislature that would require the Office of Group Benefits to cover bariatric surgery. The thought is that if state employees are covered, other state and private insurers will follow suit. I've recently been in contact with the author of the bill, Rep. Sam Jones, from Franklinton. He sits on the House insurance committee. Here's his page with the Legislature: (note the legislature site is down on Tuesday morning) http://house.louisiana.gov/h_reps/members.asp?ID=50 and email mailto:[email protected]?subject=Rep Sam Jones Mandating coverage in the state of Louisiana will be the start of a great humanitarian effort here and the state will indeed "save" money (not make, sorry) from that they now spend on health care costs for the dangerous co-morbities like diabetes, degenerative back disease, sleep apnea and hypertension. It has been observed that the Office of Group Benefits sets the standard for coverage in the state and since Medicare is already set amongst Louisiana providers, I think OGB is the best bet we have to getting Medicaid  in its truest sense for those suffering from obesity. I encourage you to write your lawmakers, not state program administrators to get this law enacted and maybe next session we can tackle the inadequencies of the Medicaid program. Onward, Frances

Frances, YOU ARE AWSOME!!!! Thank you so much for the information and I am ON THE BAND WAGON!!! so to speak!  Thank You, Sheree