Medicare/Medicaid (QMB Maryland) surgery out of state?

Joanna07
on 6/18/07 12:29 am - Lonaconing, MD
I live in Maryland.  The closest bariatric surgeon is about an hour away in Morgantown West Virginia.  I know that I can use Medicare in another state.  I have both Medicare and QMB Maryland Medical Assistance (medicaid).  My question is, does medicaid cover surgery in another state?  I would hate to drive to the closest Maryland  surgeon-about 2 1/2 hours away in Baltimore.
Kendra D
on 6/18/07 2:04 am

Hello. I do Medical Billing for several physicians. I do know that if your provider is not a participating provider with Maryland medicaid it will not be covered. We just had a patient that has medicaid in Delware and had services rendered in Maryland. Our office is not "par" with Delaware Medicaid therefore the services were not covered. My suggestion would be to find a doctor in Maryland. With a surgery like this, you don't want the  high expense. Just my 2 cents..........

Patiurple
on 6/19/07 6:03 am - Wheatland, OK
Usually medicaid is not covered in another state unless it is an emergency and then they have to call the provider and get approval. I suggest you call the medicaid helpline and see. Also check out the Maryland board for surgeons here on OH.
Joanna07
on 7/19/07 2:14 am - Lonaconing, MD
Thanks for the replies.  I just learned that the Dr. in Morgantown WV isn't even a Center of Excellence, so medicare won't pay there either.  I went ahead and mad a consultation appointment in Baltimore, even though it is a long trip for me.  I need my insurances to pay for the surgery and this is the only way.
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