Out of pocket cost with Medicaid?
Hello all! I have been around for a while, but finally needed to post. I will be losing my insurance in September, and will be on Medicaid temporarily. Unfortunately, this means that on month 4 of 6 in my 6 months supervised diet program, I will be changing insurance. From what I can gather, I will probably be approved (I sure hope so anyway...) If I am, does anyone have a general out of pocket range? I will be getting the sleeve, unless Medicaid will not cover it... then I will be getting RNY instead. I will be at the Cleveland Clinic. Thank you for your time!
If you are on/ go on a managed care plan through Medicaid such as care source, Molina, Buckeye, Paramount, they basicly from what I was told from my insurance coordnater that they cover 100%, but some of those manage care insurance do not cover all NUT appts. This is the only info that I can try to help out with. I have care source and they cover everything, I have heard of those getting the sleeve with Medicaid but I thinkthey (Care source) will only do RNY. That is something Im going to ask my patient / insurance coordnater at my next visit next week.
Best of luck.
If they end up covering the entire cost.... I would probably cry. I have been saving for 2 years to pay for surgery. I have had my therapist and nutritionist appointments and have the all clear, my pcp is doing my monthly check ins and guidance for the 6 mo. plan and my thyroid specialist is all for it, although I don't think he is part of the requirements of my current insurance. I've also had a consult with a surgeon, an ekg, various scans, and blood draws. If I am on medicaid and things go as planned, I have no idea what kind, I wasn't aware there were other types, but if they pay for it all... I can't even comprehend the burden that would take off of me. Either way, thank you for your input! I appreciate it!
Your welcome. Yes there are several different ones, don't get care source when/ if you choose, they take the longest as in a 9 month supervised diet. booo. I have 4 more months to go, but all my testing is for the most part have been/ is done this month. thankful to get all that out of the way. lol. Just thank of all the stuff you could do with that money you have saved if they pay 100%. However you might want to hold on to that savings for plastics down the road.
I have medicaid and they will be paying for everything. I go to the surgeon the second to get an actual surgery date. It even covered all of my NUT appointments and requirements from the weight loss program. I have to pay nothing out of pocket.
Most def, check out all the plans, call them and ask them what their requirements are to get it covered. Make sure the providers and pace you are having it done takes that plan! Not all of them take it. Remember even though it cost you nothing. They are not allowed to charge you any out of pocket even if it is for something that is not covered by the plan unless you agree ahead of time that you understand that such and such is not covered and you agree that you will pay set amount of money!!! I know this because I work for one of these plans. Also, remember to be good to your providers...they do this at a reduced cost than what they get from other plans or private pay!
Oh, and btw I work for one of those plans and the insurance they offer their employee's has a rider put on it that will not pay for wls anyway shape or form...but they will approve it for the members!! Thank God I now have my husbands insurance that approved me in less than 2 days.