Please help me figure this out

I want to get weight loss surgery and I am going to call social security tomorrow and ask if they even cover my getting weight loss surgery. How do I find out if medicaid will cover it? What in the world do I say and ask them when I call? Please give me some info! Thank yall so much!

Priscilla

PS I have sleep apnea, acid reflux
I am 362 lbs and I am 29 years old.

I am on disability for a mental illness. I have schizoaffective disorder. I am in recovery. I am normal. please just tell me what you think I should do!

If you are on disability, do you have the option of medicare as oppossed to medicaid? I think medicare covers more. Whoever you talk to, emphasize the sleep apnea and any other conditions such as diebetes, high cholesteral, high blood pressure you may have. If you are denied, find out what the appeal process is. My BCBS denied me, I am mad at myself for not fighting it. Good luck!

Medicaid and medicare do cover weight loss surgery  you will have to go to a center of excellence check with them and find out which hospital or surgical center they approved what their criteria is  and go from there. They will have a bariatric doctor discuss  which surgery would be best for you. They will require a psychiatric eval before you will be approved for surgery. Good Luck to you

Medicaid will pay for WLS in GA. However with the band they will NOT pay for fills. Your completely on your own with that, and it could get rather expensive trying to pay for those on disability! I got 16 fills in 14 months and never received restriction like they advertise.

I know medicaid pays for RNY. VSG and DS I am not sure about, but you might be able to appeal to get one of those covered if that is what u want.

Good luck.

AWESOME!! Thank you for the good news! How much do the fills cost?

It varies greatly. I think the average is prob. $150-$250 per fill?

My doctor charges 75 for office visit.  Then if I need a fill, it's another 75.. making it 150.00

Check with your state, policies may be different about covering fills.  And some doctor's don't charge for fills (adjustments) for a period of time after surgery.  I've heard anywhere from 3 months up to a year.

Edit: I just noticed you're in GA.. never mind about checking with your state. 

And not everyone has a hard time reaching appetite suppression.  I've had good control of my appetite with the band almost consistently.  Some people do have trouble though.. hopefully, if the band is what you chose to have done, you'll have an easy time of it.

Hi Pricilla...I am disabled, on SS and Medicare and carry a MedAdvantage insurance policy.  Medicare does cover several types of WLS.  The trick is to determine which hospital and doctors take medicare as insurance.  Bear in mind that Medicare alone has a 20% deductible, so unless you carry a supplement or have a MedAdvantage plan, you will pay 20% of all the costs (for me it was billed out at about $20K for the surgery, hospital and doctors and insurance payed about $10K, but the pre-op testing was almost as much as the surgery itself).
I had to have the following testing prior to submitting my pre-authorization:

Cardiac stress test
Sleep study
Psych evaluation
Do on-line patient education
3 month medically supervised diet with nutritionist

Good luck, there will be a lot of phone calls to make to find a hospital that contracts with Medicare + is a COE (Medicare approved) + a doctor who will take Medicare.  In the Seattle area, there was ONE and I have to travel 60 miles for my follow up visits.

Steph