questions from a new member: madison and badgercare

Hello all -  I just joined OH this week, and am just starting on the journey toward WLS.  I will be attending the information seminar in November, and already have a referral from my PCP.  My partner has been incredibly supportive (despite being terrified beyond words) and I've done lots of research and am feeling pretty well informed.  I have 2 questions: First, has anyone had WLS with Drs. Garren or Gould in Madison?  I've heard they have a reputation as some of the best, but I'd like to hear some first hand testimonials or experiences. Second, has anyone gotten their WLS approved through BadgerCare?  I have Unity through BadgerCare, and I know that although Unity doesn't cover it, BadgerCare has to, so I'm anticpating kind of an uphill battle.  I'd love to know if anyone has done this before, or if I am breaking new ground here.   Last, I'd love just to be in touch with anyone in Madison or the surrounding area for general support or questions... 

Thanks so much,

xmasmama

Hi there, I have had badger care insurance since 2004 and it has been a struggle! Even with my co morbities they would NOT cover the surgery, my advice get all copies of mds records, tests , and thing that is a health issue with your weight and keep it in a binder, there are some clinics out there which will help you try to get it covered, the 2 Bariatric Centers that I went to  I both was turned down, and to appeal it takes alot of time and sometimes money to fight the state. I have a different insurance that covers it now, but it was a constant battle with the state insurance! Good luck! I am from Sheboygan area, and have not dealt with any doctors in Madison, but just take one step at a time ! Good luck Lisa3959

WELCOME TO THE WI BOARDS!!!!!!!  I'M MARIE AND I HAD DR. GARREN AND HIS STAFF AT MERITER AND I HAD A PRETTY GOOD EXPERIENCE. HE'S VERY FUNNY AND UNDERSTANDS WHAT WE ARE GOING THROUGH. THE STAFF AT THE CLINIC IS GREAT TOO!!!!! FOR YOUR 2ND QUESTION I HAVE MEDICARE AND MEDICAID AND I WAS NEVER DENIED BUT I HAD BEEN SEEING MY PCP FOR ABOUT 1 1/2 YEARS ABOUT MY WEIGHT, I KNOW THAT THEY BOTH HAVE SPECIAL REQUIREMENTS TO HAVE THE SURGERY. I HEARDTHATFOR MEDICAID YOU HAVE TO HAVE 6 MONTHS OF REGULAR VISITS WITH YOUR PCP FOR YOUR WEIGHT,AND FOR MEDCARE YOU HAVE TO GO TO A CENTER OF EXCELLENCE WHICH OUR CLINIC GOT IN DECEMBER LAST YEAR. ALL IN ALL IT TOOK ME FROM AUG.2006-JUNE 2007 TO HAVE MY SURGERY. JUST DON'T GET DISCOURAGED ABOUT ANYTHING. I HAD MY SURGERY JUNE 5TH AND I HAVE LOST 70+ POUNDS AND i FEEL GREAT!!!!    IF YOU EVER NEED A FRIEND MY EMAIL IS [email protected]. FEEL FREE TO CONTACT ME ANYTIME!!                 HUGS...MARIE

I have BadgerCare... my HMO is CompCare (GroupHealth)... and I had an *easy* time with approval.  I was required to see a dietician once a month for 6 months.  I had no real co-morbid issues,.. but my surgeon did indicate that I had beginning stages of edema.  I was approved within 2 days of the pre-auth being submitted to the insurance. Good luck!

Hi xmasmama!  I'm also new to the board.  Dr. Garren is doing my surgery on 12/18, and I'm so excited I could hurl.  These are going to be the longest 3 weeks of my life!  (And I think it's only going to get worse once I have to start all-liquids next week!)  I work in Madison, and used to live on the east side, but just bought a house in Portage (CHEAP!).  I went to my first seminar exactly a year ago, and it took me until the middle of October to get WPS to approve it.  I'm amazed at how fast it's moved since then! I've been really impressed with their whole team so far.  I had nutrition class with Diane last night, and she answered a lot of the questions I had left but didn't want to ask (like, why can't I have decaf coffee?).  My only complaint is with the psych test - over 600 true/false fill-in-the-bubble questions!  It was like my worst high school nightmare all over again - I HATE endless dot tests!  But, it's over now, and I have proof that I'm not crazy! ;P

Are you doing RNY or LAP-BAND?  (LB myself.)

Hi, I just joined OH tonight, I have BadgerCare with Compcare for my HMO.  I have chronic knee pain arhritis.  I have been to several doctors about my knee and had several different treatments that have not worked and I am too young for knee replacement.  Dr.  suggested losing weight.  I have not been to Dr. for my weight.  Would not seeing Dr. for my weight make it harder for me to get approval for WLS with the BadgerCare?  I am just now looking into the surgery, so I have no idea at all about approval issues.