It's looking like no plastics for the kid!

JazzyOne9254
on 6/4/12 10:25 am
I went to my fifth...or sixth ...consult today for thigh skin excision/thighplasty, and the doctor doesn't even take my insurance!

I was referred to him by my PCP, who I have an appointment with tomorrow. I'll discuss the outcome with her.  There's nobody else for me locally, so I would have to look at Carmel/Indy again, and the insurance issue comes up again - taking one but not the other.

I think I have spent all the energy I can on this...I have other things to do, and I'm just hitting one brick wall right after another.

As long as I keep my clothes on, I'll look OK.  I juat hope I don't get any infections this year.  Cellulitis is no joke, especially in the summertime! 


HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

Huneypie
on 6/4/12 7:21 pm - London, United Kingdom
DS on 07/24/12
All the best for a positive outcome with your PCP.  I'm not sure what you mean about taking one and not the other, but I'd definitely travel if that's at all possible.

Lowish BMI? See Lightweights Board! Lightweight Creed For more on DS see www.DSfacts.com
If you don't have peace, it isn't because someone took it from you; you gave it away. You cannot always control what happens to you, but you can control what happens in you John C Maxwell 
View more of my photos at ObesityHelp.comSleeve 2010 Dr López Corvala, Mexico. DS 2012 Dr Himpens, Belgium

I  my DS  

JazzyOne9254
on 6/5/12 1:38 am, edited 6/5/12 1:42 am
Thanks for all the advice, I appreciate all of you!

There is an extra kink that many of you may not be aware of.

I have been on Social Security Disability since 2005.  The likelihood of my getting Care Credit is very slim, since my only income is my Social Security Check, and multiple medical bills have made my credit look like a lace curtain.

My SS check is "high", so I only get Medicare and Medicaid with a very high spendown, which essentially wants  the remainder of my Social Security Check, before they pay for anything.  So, I basically have Social Security and Medicare.

Huneypie, traveling within my state is the only option.  I don't have a job, and this was the last piece of surgery for me to complete Voc-Rehab, (I've already done three semesters worht of work) get into a different profession, and get on with life.  My VR counselor advised me to complete all major surgery before continuing with my program.  I have a college degree, but my former profession is too physical for me to continue with lupus and fibromyalgia.   I've just spent so much energy on this, that I feel I need to just back off, suck it up for a minute, and revisit this later, though, since I'm 54, I don't have much more time to complete Voc-Rehab -and- have surgery.  Age comes into play when you talk about feasibility for a re-education program.

I think If I had been in my 20's or 30's or even my 40's,  doctors would have been more willing to help.

Oh and so much for hoping cellulitis stays away...working on a new infection today, likely the  result of wearing my compression garment yesterday. 

Cellulitis is the reason for needing this surgery in the first place.  I just don't understand whey these doctors don get it!

HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

Huneypie
on 6/5/12 4:45 am - London, United Kingdom
DS on 07/24/12
Wow 54 - I'd never have guessed, you look great!

I've seen some of your posts on retraining and I think it's great what you're doing.  It'd be so easy to just give up and if you have to stick with what you're doing now then it's good you're able to prioritise.

Hopefully you can still get plastics when you finish studying.

Lowish BMI? See Lightweights Board! Lightweight Creed For more on DS see www.DSfacts.com
If you don't have peace, it isn't because someone took it from you; you gave it away. You cannot always control what happens to you, but you can control what happens in you John C Maxwell 
View more of my photos at ObesityHelp.comSleeve 2010 Dr López Corvala, Mexico. DS 2012 Dr Himpens, Belgium

I  my DS  

JazzyOne9254
on 6/5/12 1:49 am, edited 6/5/12 1:51 am
Huneypie -

RE: taking one and not the other-

That was in reference to insurance plans - They'll either take Medicare, but not Medicaid, or they don't work with the private company that supplies my Medicare Complete policy, or they take neither.

I would like to hear from the poster that once said I "knew how to work the system."  I  sure as HECK don't!

If I did, I wouldn't be having this issue now.

The whole point of having WLS was to get back to work...I've been on disability due to SMO, lupus, fibromyalgia and a few other health issues, since 2005.

HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

Jolly Rancher
on 6/5/12 9:17 am
Very few reputable plastic surgeons contract with ANY insurance company. At best, we get out of network benefits, and I'd venture a guess that almost all of us have or will have to jump through the same hoops - no matter who our insurer. I don't know what other issues

I don't pretend to be a doctor by any means, but how is plastic surgery on your thigh supposed to improve your cellulitis? Don't open wounds, including surgery, increase te odds of a flare up? It seems counterintuitive to me, but again, what do I know? Also, I've heard there is increase chance of lymphadema with thighplasty.........which also encourages cellulitis, no?

I do agree. It's probably time for you to move on, and look for alternative solutions.
Janice

320/170/150
SW/CW/GW
JazzyOne9254
on 6/6/12 2:46 pm, edited 6/6/12 2:48 pm

Cellulitis is not a constant.  It is an infection of SC fat. It is an opportunistic infction when germs find their way into the skin.  It can happen if your skin is too dry and cracks, and germs get in. 

Thighplasty could make my lymphedema worse, and trauma of any kind could even set off a lupus flare.  Getting my DS could have sent me into flare mode, too.  When the benefits outweigh the risks, (sepsis from cellulitis vs. no sepsis ), you go with what could help the situation, despite the risk.

As I said, the skin has now also become a hygiene issue.  And I'm dealing with yet another bout of cellulitis as I'm writing this.

Compression garment abrasion is again the likely cause.  

I can't afford to drop $1750  for a smaller one every time I lose ten pounds!  They're custom made in Germany!

Medicaid paid for the first one, because I didn't have disability yet. but once the Social Security check started, I wasn't eligible for anything, ( no Food Stamps, I think they call it SNAP now) and the spend down literally leaves me with nothing to live on! Doesn't even take into consideration my vites and Rx meds, even though the vites are medically necessary!  Even for Rx, they do an allowance of average cost, not what it's actually costing you, so you can submit documents all day long, and it makes no difference.

This is a very screwed up state when to comes to dealing with stuff like this.


HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

nightowl
on 6/6/12 5:21 am - Topeka, KS
If your state has a state-sponsored medical school with attached teaching hospital, I think such hospitals usually accept Medicare and Medicaid.

Alternatively, since this surgery is so important to your future employability, have you considered switching from your AARP privately-administered Medicare to straight/traditional Medicare?
southernlady5464
on 6/6/12 5:55 am
The problem with straight Medicare is that Part B (the hospitalization part) has an 80/20 cap...they pay 80%, you pay 20%. The Medicare Advantage plans (AARP/UHC being just one of them) usually take care of that 20% but only with doctors/hospitals that already accept regular Medicare.

It's the 20% for Part B that is the killer.

Liz


Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135






   

nightowl
on 6/6/12 12:53 pm - Topeka, KS
For her case, the Medicaid as secondary would have a good chance of covering the 20%, or the hospital who accepts the Medicare/Medicaid combo may eat the loss if her state's Medicaid is stingy.
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