MEDICAID AND MEDICARE SURGEONS LIST!
I have both MassHealth and Medicare. I have been going through Beth Israel with no problems with insurance at all. I just got my surgery date, June 3ed, and when the doctors assistant was setting up my appointment she said that with MassHealth it was going to be a little bit of a wait for them to approve it. When she saw that my main insurance was Medicare she said there would be no wait and we are ready to go on that date.
I was really nervous because Beth Israel is new to me but everybody over there has been great.
I really hope that all of this is true,I have masshealth and medicare and would love to get a gastric bypass,it is something I have thought about for a long time but never imagined would ever happen. So i fully intend to call both insurance companies on monday morning and see what happens. Is it really tough to get approved? I want to describe my situation a little and maybe some of you could give you're opinions? I am 29 yrs.old approx. 301 pounds,I have several medical conditions that could be improved by weight loss such as: asthma,pre-diabetes,high blood pressure etc. So if anyone could kindly give their opinion as to wether I sound like a good candidate please do. thank you.
Hi Crissy,
I have tried every diet you could think of and nothing has worked. Sure I would lose weight but as soon as I went off the diet I would gain twice as much back. I am 42 and weigh 263 pounds. I always wanted to have surgery but never thought it was possible because there was no way I could afford it. I kept bringing up my weight to my doctor and she would just say that it was normal to gain weight as you got older, this was unacceptable to me.
The clinic I was going to had declined a great deal so I switched my PCP over to Beth Israel. On my first visit with my new PCP I told him that my weight is way out of control, he agreed and set me up with the Bariatrics department in Boston. I expressed my concern of not being able to pay for it and he told me that MassHealth and Medicare now cover it because it cost them more in the long run due to all the health problems that obesity causes.
If Medicare is your primary insurance you will be all set without going through the whole program and then having to wait Lord knows how long for MassHealth to approve it. However, there is a one time program fee of $500.00 that you have to pay on your first visit and there is no way around that.
I have tried every diet you could think of and nothing has worked. Sure I would lose weight but as soon as I went off the diet I would gain twice as much back. I am 42 and weigh 263 pounds. I always wanted to have surgery but never thought it was possible because there was no way I could afford it. I kept bringing up my weight to my doctor and she would just say that it was normal to gain weight as you got older, this was unacceptable to me.
The clinic I was going to had declined a great deal so I switched my PCP over to Beth Israel. On my first visit with my new PCP I told him that my weight is way out of control, he agreed and set me up with the Bariatrics department in Boston. I expressed my concern of not being able to pay for it and he told me that MassHealth and Medicare now cover it because it cost them more in the long run due to all the health problems that obesity causes.
If Medicare is your primary insurance you will be all set without going through the whole program and then having to wait Lord knows how long for MassHealth to approve it. However, there is a one time program fee of $500.00 that you have to pay on your first visit and there is no way around that.
You sound like a great candidate to me!
I went via Boston Medical Center and had who I think is the best surgeon in the Universe
Dr. Hess for my surgery. I am only 6 days out..but I would move and pay any amount of money to have him do my surgery. but I am on MassHealth right now and his office accepted it.
There was a lot of problems getting it through though ..it took me almost 2 years. I started out with BlueCross Blue Shield, lost my job..had Cobra then massHealth.
I am 45 and am 215 but I'm only 4 11 which made it worse..I had all plus sleep apnea that you had.
I'll see what happens in the next year.
Good luck and if you need to talk, I'm here
I went via Boston Medical Center and had who I think is the best surgeon in the Universe
Dr. Hess for my surgery. I am only 6 days out..but I would move and pay any amount of money to have him do my surgery. but I am on MassHealth right now and his office accepted it.
There was a lot of problems getting it through though ..it took me almost 2 years. I started out with BlueCross Blue Shield, lost my job..had Cobra then massHealth.
I am 45 and am 215 but I'm only 4 11 which made it worse..I had all plus sleep apnea that you had.
I'll see what happens in the next year.
Good luck and if you need to talk, I'm here
Dr. Sheldon Randall of Hallmark Health specifically Lawrence Memorial Hospital in Medford. He accepts Mass Health and Medicare. Mass Health ONLY covers the RNY gastric bypass. It is a mandatory 6 month wait. Medicare WILL cover Lap Band OR RNY gastric bypass. It is a 3-4 month wait. His statistics are fantastic. I liked him. Very confident. No nonsense, no BS. He has high expectations of his patients.
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