Question in regards to medicaid

Tristalyn
on 8/20/16 2:14 pm
VSG on 03/24/17

I've currently hit a wall in my journey to have weight loss surgery. I've gone through the 6 months medically supervised diet. I've had the EKG and the stress test and got the clearance letter from my doctor, and now I'm ready to schedule my surgery. The problem is, the place I'm going to wants $1500 out of pocket. My insurance covers the surgery 100%. I'm really not positive what this out of pocket cost is for. It doesn't even include the food they want me to buy from them the few weeks before and after surgery. There's no clear reason what it's for other than it's "Their charges that insurance won't cover"

My question is. Is this normal? I've contacted another surgeon in my area (I'm in Knoxville, TN and have contacted the Foothills Weight Loss Center with Dr. Colquitt) I haven't heard back to see if they also have this charge, but I know of a friend who has medicaid and going through this process and her doctor does not require any out of pocket from her. So I don't know really what to do. It's the only thing holding me back. I'm disabled and my husband does what he can, but we are a low income household and $1500 is just outrageous to us. It's not something I'll ever be able to save for. 

 

Any thoughts/comments would be appreciated. Thank you.

White Dove
on 8/20/16 3:44 pm - Warren, OH

Many surgical centers have an additional fee like that.  It should be discussed from the beginning of the process and not come as a surprise after you have gone through the hoops or surgery.  Every center does not do that so ask first. 

Real life begins where your comfort zone ends

perksgirl119
on 8/20/16 8:51 pm - SURPRISE, az

I also have Medicaid I'm be sleeved on the 6th I have 100% coverage not out of pocket expenses ask and she it varies from state to state I think I'm in Arizona 

CJ On Orcas
on 8/20/16 9:12 pm, edited 8/20/16 2:12 pm
RNY on 09/09/16

I am on Apple Health (medicaid) and it is covered at 100%, no out of pocket.  I did have to jump theoygh a LOT of hoops but it is worth it.

 

*edited to add rhat I am scheduled for RNY Sept 9

Liz WantsHealthForAll
on 8/21/16 3:20 am - Cape Cod, MA
VSG on 03/28/16

My surgical center has a $500 fee which covers non-clinical classes, support groups etc.  they disclose it when the first appointment is made. They will do a payment plan for those who need it, but I don't know if they ever "adjust" it for lower income people.

Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-125 CW: 119ish

Citizen Kim
on 8/21/16 11:02 am - Castle Rock, CO

Weight loss surgery has become a massive money making venture for general surgeons.  Shop around.  Someone on Medicaid should not have to pay these ridiculous fees.  If you could afford them, you wouldn't be on Medicaid ...

 

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

WyomingMom
on 8/21/16 8:06 pm
VSG on 08/09/16

My surgeon wanted $2,000 before surgery and then I had to pay the hospital another 1,500.  They checked with my insurance company to see what my out-of-pockets expense would be.  I hadn't yet met my deductible so I had to pay out a lot right before surgery. This is becoming more common all the time unfortunately.  Hospitals get stuck with a lot of unpaid bills so they're starting to demand money up front.

I hope it all works out for you.

 

kyzze
on 8/21/16 8:41 pm
VSG on 12/29/15 with

Maybe you can call the Medicaid hotline and let them know what is going on and hopefully they can get a representative who can help you with this. 

Kyzze

 

Kala2032
on 8/22/16 4:28 am - Marrero, LA
RNY on 02/08/16

I think what she is looking for anyone in the Knoxville or surrounding area or vicinity or maybe they know of a doctor that would be taking new medicaid patients. If it meant traveling in the Tennesee area, so be it but it seems she is eager. 

Height 5' 10, HW: 538 lbs 05/2015, SW: 444 lbs 2/2016, CW:213lbs 8/2017







Tristalyn
on 8/22/16 10:25 am
VSG on 03/24/17

Thank you everyone for the replies. I had Dr. Colquitt's office contact me from Foothills Weight Loss and they only have a $500 out of pocket fee. She had that includes the dietitian, 6 month post op with the fitness center, etc etc. Which is a whole lot better. I just have to have $200 upfront and I can make payments on the other $300. This is still gonna be tough, but it's a whole lot better and not as scary and defeating as the other one.

I'm starting over though, so I'm taking their seminar now and gonna go from there. Thank you again. Wish me luck on my journey! 

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