Medicaid

Hi, Could anyone tell me if they were able to have the surgery where medicaid insurance covered it? Especially, in the past 6-12 months. I have only been able to find where people were approved on medicaid from 2003 and early 2004. Any information that is offered would be so appreciated! Thanks....Kristy

Christy, have your tried Dr. Scarborough? I know several of his patients had Medicaid. Also, I think Emory takes Medicaid. Hope this helps! Barb in S. Ga

Thanks Barbara! I have not looked into surgeons yet; I am actually awaiting to see if I am approved for Georgia Medicaid. I just recently applied. I feel as though this is my LAST chance for this surgery. I have tried so many other routes! Thanks again...I hope to be finding a surgeon very soon!! Kristy

Kristy I just got approved by Medicaid last week on Wednesday. If you have any questions, feel free to email me. I live in GA also. Tanya

Hi Kristy, Welcome I have medicaid also and have been told that medicaid is very accepting of this procedure. I want you to know that there is out of pocket expenses and you have to find a doctor that accepts medicaid. My out of pocket is around $1000.00 so far. That is pre-op stuff only. Does not include vitamins or any other nutritional things you may need post op. My doctor seems very skilled and personable. His name is Dr. Clarence Hixon. If you'd like more info please email me. I'd also be happy to share any info that I have collected since starting my journey. Wishing you the very best, Barb

Thanks Barb! I am hoping that I will have good luck with this route. Are there only certain medicaid plans that will approve this surgery? I applied for the medicaid with children. I'm not sure how the state handles the adults, but I will be persistent in finding out :0 Do you know if they have a 'pre-exist' wait? Will I need to be on the medicaid program for a certain amount of time before pursuing the WLS? I will look into Dr. Hixon. Where in Ga. is he located? Any info. you have gathered and would be willing to share, I'd be interested in Thanks so much! Good Luck in your journey!! Kristy

Kristy, one of the problems you'll face with Medicaid is finding a surgeon who will accept their payment. I was having lunch with a Bariatric surgeon in Atlanta last week and he showed me where he had done a gastric bypass procedure on a lady, billed Medicaid $8,500.00 (his fee) and received a check for $432.00! Needless to say, this was his last Medicaid case. He said while his expenses continue to sky rocket, Medicaid and insurance reimbursements continue to drop. There is simply no way a surgeon can spend 4 hours in an OR and receive a $432.00 payment for his services. Something is going to have to give very soon. Best of luck! Rick Blairsville, GA

Thanks for the response Rick! I have not begun the search for a surgeon that accepts medicaid. I know that will be an obstacle I need to face. If there were another way for me to pursue my WLS journey, I would try any routes! Hopefully, this will work out for the best. Thanks again, Krsity

Kristy, My friend had this surgery paid for by medicaid at the Augusta Medical Center last July. I will get you his name. I met him and his staff and they were wonderful. Reese

Hi Reese, I would appreciate any info. you could offer! Did your friend have the RNY? Open or lap? How is he doing? Thanks so much! best of luck to you and your friend.... Kristy