Any one on Medicade get approved

cindyl57
on 11/5/04 4:41 am - Moore, OK
I have a friend that lives next door to me. She is the sweetest nicest person you could ever know. She works very hard around her house helping her mother and all her family and friends. She took the pondimum and had severe damage to her lungs. She now weighs about 330 lbs is 5ft tall. I worry about her health so much. She is on SSI and medicaid...Se would like to know if they will pay for this surgery. I believe that if she could lose the weight she would be able to return to work. She has to use oxygen much of the time, but it doesn't slow her down. She also has bad knees...I think that if she could lose some of the weight she would be so active that her lungs and heart would be much better. She has tried all the diets like the rest of us here. I just want her to be healthy. I love her and want to see her feel better. Cindy
chris B.
on 11/5/04 1:01 pm
Does she have medicade or medicare? It is my understanding that medicaid will not pay for surgery but medicare will. My wifes cousin has medicare for disability reasons and they paid 100% of her surgery. She had surgery about 2 years ago so I am not 100% sure f they still pay for it or not. Just know they did at the time. Once she decided to have the surgery she went in to the doctors office, submitted paperwork and had a surgery date within a month. My wife was on medicaid for a short time after her last pregnancy and they would not pay for such surgery. Hope this info helps.
wealthgvr
on 11/10/04 5:09 am - Edmond, OK
Cindy, Your friend may have Medicare as primary since she is disabled and then the medicaid program for Oklahoma covers the gaps that medicare doesn't cover. If that is true, then she may have an out of pocket co-pay of less than $900 for the surgery, plus about 20% of the pre-op tests. That may come to $1200-$1500 total which is sure less than $25,000 - $30,000 if she would pay out of pocket. I would definately discuss having her attend a seminar and see if she is as committed to WLS as you are. I recommend the program at Edmond Medical Center. They have 3 surgeons and the seminars are done on the 2nd and 4th Tuesdays of each month. Talk to your friend, then call Shelly at 341-0511 and get her on the list for the next seminar. Good Luck!! The seminars are free, so it will give her a good indication of whether or not she wants to have WLS without costing her anything. Sherry
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