medicaid and lap band

on 1/10/08 1:02 pm - champaign, IL
As you all know my insurance denied me for lap band according to my sister I should apply for medicaird but i am not really familliar on medicaid she had told me  about a hospital that accept medicaid as payment for lap band and she want me to go there  she had spoke to the hospital and they want me to attend the seminar on jan.16-2008 however in fear of the all situation I really don't know what I am putting myself true Medicaire anyone who have experience or had there surgery cover by medicaire can you please explain to me how it work did the hospital have to apply for me or i have to apply and also what is the emergency medicaid and how long will you wait if approved and what do they need to approved you?
on 1/10/08 1:44 pm - Taylor, WI
I am in Wisconsin, so not sure about your state.  Here to be on Medicaid you have to apply at the county Social Services office and have low enough income to qualify.  Call your local Social Serives office to get more information from them, and possibly make an appointement to apply for services. Beth
Dee Kay
on 1/10/08 2:18 pm
You can try going to to obtain more information about Illinois Medicaid.  

For information, call the Illinois Department of Human Services (DHS) Helpline at 1-800-843-6154, Monday through Friday (except state holidays), between 7:30 a.m. and 7:00 p.m.  Persons using a teletypewriter (TTY) can call 1-800-447-6404.  The call is free.

You may qualify for medical benefits if you:

  • are a U.S. citizen or meet certain non-citizen requirements.  (Ask your caseworker about these requirements.);
  • are an Illinois resident; and
  • meet the following program requirements.
    • Income and assets All your earned income, and unearned income are reviewed when you apply for medical benefits.  If you are age 65 or older or are disabled or are blind, your assets will also be reviewed.  Earned income is wages from your job or profits from your business. Unearned income includes money from Social Security and any other money you receive.  Assets are the things you own.

    • If you have too mu*****ome or assets to be eligible for medical benefits, but you meet all other eligibility requirements, DHS may put you in the medical benefits spenddown program.  If you participate in the spenddown program, payment will be made for some of your medical care each month after you show your caseworker medical bills that equal a certain amount.  This amount is called your spenddown amount.

      You will receive a notice telling you the amount of your spenddown.

    • Health insurance You must also give DHS any information you have about your health insurance.

    • Proof of disability, blindness or age

If you are getting cash from the federal Supplemental Security Income (SSI) program or have applied for and are approved to receive SSI, Social Security disability or Railroad disability benefits, this will be accepted to prove that you are aged, blind or disabled.  If you do not receive these benefits and do not wish to apply for them, then your age, blindness, disability or incapacity will be evaluated by DHS.

Dee Kay (5'6" and 40-something yrs...)

on 1/10/08 8:47 pm - Humboldt, TN
 Medicare USUALLY isn't available unless you are disabled or are 65 years old. a government insurance plan for people that do NOT have a large income.....or any income......  My State is Tennessee...If you EVER had automatically got Medicaid.... TennCare.....NOW dissolved ....... Tennessee has Cover Tennessee and employers must agree to pay a portion of the cost the employee MUST cover the other part.  Medicaid is STILL available if you are on SSI or low /no income.  USUALLY finding a surgeon that will take Medicaid will be the problem.  Now if you have medicare  and Medicaid....Finding a Center of Excellence is the issue.......Medicare WILL NOT pay.......unless it is an approved hospital and an approved surgeon.    You can contact your Medicare/ medicaid carrier and get specific guidelines ......there are several different guidelines out there. BUT if you want WLS bad enough YOU can work the situation out!  My Lap RNY was covered by Medicare and Medicaid......I only had to pay for the nutritional counseling.................  I wish you all the LUCK in the world

Work like you don't need the money......

on 1/11/08 2:04 am - champaign, IL
Thank you so much for your feed back
on 8/12/08 2:21 am - london, KY
Medicare is approved by social security for eldery or disabled.
medicaid is approved by the state(food stamp office or dss office). For people with limited
income or pregnant women. People with private insurance mainly is not eligable.
This surgery is for people who is over 100 lbs of there normal weight.
on 9/15/13 9:22 am

This surgery is for people who is over 100 lbs of there normal weight.

THAT is not is for anyone who is a 40 BMI or over or those who are a 35-40 BMI with comorbids.

I was ONLY 55 lbs overweight but was a 35.s BMI AND had comorbids.

Now, to the original poster...unless you are between 30-35 BMI, GO for the VSG and stay away from the lap band.

Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135


on 9/1/08 9:22 am - Mallory, WV
All my evaluations went well in my favor for the lap band surgery...Now medicaid is the problem...Im in WV..and I need help...does any one know of a doctor who will take it and know that medicaid will pay....Ive been told you need to be near death to get it...bed fast--walker--oxygen--wheel chair.....I dont know why we gotta go thru this to be given a second chance at life..can any one shed any light on this for email is [email protected]
on 9/1/08 10:16 am - champaign, IL

medicaid pay for my surgery and all the test my surgery is schedule for this friday I am on a liquid diet now also I am from illinois I have no clue about wiscon
on 9/2/08 12:24 am - Mallory, WV
............Thank you so much for replying..Im gonna try to call the doctors here today and see if any thing has changed..last I knew a couple of months ago they wouldnt take it..unless i was on a walker or bedfast and on a breathing machine...its sad how they try to keep people from getting better and living a normal on so many meds for different things, it would save them money...thanks again for replying!

[email protected]
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