Question:
Does anybody know of anyone who has had the surgery and medicaid paid for it?

I'm trying to get all the information I can on the surgery and weather medicaid covers it. My sister just turned 17 and she wants or should I say needs to have it done. She's 17 5'3 and about 260pds. I would appreciate any suggestions or comments. Please email me at [email protected]    — [Anonymous] (posted on September 11, 2000)

September 11, 2000
I have medicaid and it paid 100% of the surgery. I no many all over the country with medicaid and have had the surgery. There is usually no problems and sometimes it takes time to get approval, but usually approved on the first time.
   — chris M.

September 11, 2000
Medicaid is a federal program and yes they do cover it if you meet their criteria. However, contrary to what some have said there is some leeway in that the feds allow the states to administer this. Each state can set up its own criteria. There is a HCFA website you may wish to explore and I am sorry I cannot elaborate more on this. Early on in my research I explored this site and the criteria are listed there for federal guidelines. Basically as I remember it was respiratory or cardiac comorbids required. I now have great difficulty getting around this site and cannot seem to get back to where I found this info. I have insurance thru the Medicaid program and in my instance the state has issued no Medicaid guidelines therefore my insurance defers in Medicaid cases to the guidelines issued by my insurance. For me this is better because I do not have the federal comorbids, but believe I meet their criteria which allows joint disease and ambulation difficulties to be a comorbid. At this point are you straight Medicaid or do you have one of the insurance plans Medicaid funnels one into...insurance-title 19? The whole thing is woven...very tricky. Overall I think your chance for success is higher than with private insurance. This question has been asked many times and there are many here who have had it approved under Medicaid.
   — JennyLynn A.

September 12, 2000
I have a friend who is on medicaid and the same surgeon who did my surgery, did hers. Unfortunately things did not turn out the same as they did with me. My friend though on medicaid does not have the same outlook on life as I did. She would not take her vitamins the way she should or even make her follow up doctors visits the way she should. She ended up having to go back in the hospital for several days due to throwing up excessive blood. My surgeon now is being very selective who she chooses to do the surgery for. It is sad because I have referred many people to her. "One bad apple can spoil the entire bunch". A month after surgery my friend was smoking marijuaina like it was going out of style. In talking with my surgeons nurse I kinda figure my surgeon is skeptical because anything could have happened to my friend and that could have cause a major law suite. This may or may not be the type of person your sister is, but I am just giving my experience of meidicaid recipants having this surgery.
   — Barbara P.

January 4, 2005
I have medicaid & medicare because of a back injury/disability. I was approved with no problem; not even a psych eval. I have been very fortunate! Sherry D
   — Sherry D S.

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