Question:
Has anyone self-payed the surgeon, but used Medicaid for the hospital bill?

My daughter's primary ins. is Bluegrass Family Health. Secondary is Medicaid(SSI). I anticipate some problems with her primary insurance. The doctor she has chosen does not accept medicaid, but the hospital does. She has someone that is willing to help financially. I'm sure medicaid will pay for RNY (20 yrs of age, BMI of 61 with comorbidities, but the doctors that accept medicaid have 4 month waiting lists just for a consult. It sounds simple to me to self-pay the surgeon(my daughter has someone who wants to do this for her), and have medicaid pay the hospital bill.I need feedback from anyone who has something to share.    — LaDonna S. (posted on January 22, 2003)

January 22, 2003
My original plans were to pay my surgeon myself(because he did not take Medicare) and have Medicare pay for the hospital. However, our insurance thru my husbands employer has now said they should be primary and not secondary, so this has thrown a monkey wrench in the works.We are trying to untangle this mess. But yes, I think you should be able to do this.Call medicaid and ask about the hospital charges. Good luck.
   — Leslie E.

January 22, 2003
Just something you might want to think about...your daughter will have lots of follow up visits with her surgeon over the next few years and if he doesnt take medicaid she will have to pay for thoose as well. Since someone is willing to help your daughter with the cost of the surgery that is great but what about the follow ups?
   — Becky M.

January 23, 2003
You mentioned your daughter was on SSI -- as a former Claims Representative for Title XVI (SSI) I suggest you check with the Social Security Administration about the offered payment. It could be considered as a "gift," and thus as income. Petty? Yes, but that is the way SSI goes. I've seen users and abusers in the system but I always felt sorry for the ones who innocently did something SSI ruled as "wrong." I suggest you check on it; better safe than sorry. Nina in Maine
   — [Deactivated Member]