ANYONE IN FLORIDA! I NEED HELP!

Amy_Lou
on 7/22/12 8:41 am, edited 7/22/12 8:41 am - FL
I've been on Medicaid Medipass for the last year, and it covered my bariatric and knee surgeries. It has honestly been a God send. Just last week, I received a letter in the mail, saying that I no longer have insurance because there is a change being made from Medicaid to Medicare. Anyway, I was instructed to pick a new insurance company from the list, before August 16th, and I am CLUELESS as to which one! I've been given 20 choices, but I have to keep future plastic surgery possibilities, and my RNY post-op needs in mind when choosing my new insurance. I HAVE been getting rashes under my abdomen and left breast due to my weight loss... and I may need to get plastic surgery for this someday. I do know a few people that have been covered by their insurance for plastic surgery; but they are not in my state, South Florida. Below are my choices. Can anyone with experience please put me on the right path? I'd truly appreciate it.

Simply Healthcare Plans, Inc.
Staywell Health Plan of Florida
Sunshine State Health Plan, Inc.
United Healthcare of Florida
Universal Health Care, Inc.
Vista, Coventry Health Plan of Florida, Inc.
AMERIGROUP Community Care
Buena Vista, Coventry Health Care Plan of Florida, Inc.
Freedom Health, Inc.
CareFlorida
Humana Medical Plan, Inc.
Medica Health Plans of Florida
Molina Healthcare of Florida
Clear Health Alliance
Preferred Medical Plan
Medicaid Medipass


Thank you and God bless! 








';*;'*Amy Lou*;',*; 
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pamislovely
on 7/22/12 11:41 am, edited 7/22/12 11:43 am - FL
 Hey there, I feel your pain, getting insurance changed is no fun.

Dr Kahlil Shillingford in boca raton was my surgeon and he took a ton of insurances; you can call his office at 561- 483- 8840 to ask but i know he takes
 Medicare and many of the hmo's along with some other Medicaid plans

He is also an awesome surgeon!
pamislovely
on 7/22/12 11:42 am - FL
Amy_Lou
on 7/22/12 1:12 pm - FL
What kind of surgeon is Dr Shillingford?
Reason I ask is, I am already post-op rny.

Thanks for the reply, Pam!  :)

';*;'*Amy Lou*;',*; 
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pamislovely
on 7/23/12 10:36 am - FL
He is a bariatric surgeon, he does lap band, bariatric and sleeve operations.  He also does general and laparoscopic surgery
www.drshillingford.com

Just call his office manager, nancy, she is a doll and will help you.
Ms.nee07
on 7/25/12 11:22 am - FL
Fr. Jorge Zaidon is a plastic surgeon and he works out of Mercy Hospital located in Coconut Grove. He accepts Vista, Coventry Health Plan Of Florida.
Dolores L.
on 7/29/12 12:48 am - FL
Revision on 08/14/12
 Amy Lou, Have you thought about straight Medicare/Medicaid?

Not sure if you would qualify or not (there might have to be some kind of disability), but perhaps you could talk to medicare about it. I know most, if not all, of those plans you cited are HMO's. I don't know if any of the insurance companies themselves would be able to give you a straight answer about exactly what they cover and what they don't - and probably most surgeon's offices can only give you an idea, because any kind of plastics procedure is highly scrutinized and can be tough to get covered, even if it is needed.

So, it sounds like you have a few issues to tease out: what kind of surgery you will need, what kind of medical problems must co-exist to get insurance coverage for that surgery, which surgeon to choose to do the surgery that will not only take your insurance but will work with them to get your surgery approved, and which insurance would consider covering you for that/those procedure(s) to begin with. That's a lot of balls in the air at one time!! The reason I wondered if straight MCR/MCD might work for you, is that there are a lot less hoops to jump through than with the HMOs. So, even if you go with a medicaid HMO to get you through in the interim, I'm wondering if you might have some better hope with medicare? Just a thought. 

And one final thought: find out which of the insurances that your PCP takes. If you like your current PCP and want to stay with them, this might be the most important question. Your PCP will an important advocate for you with both the surgeons and insurance companies. It's hard to find a PCP that gets "you" so once you get that, hang onto it! JMHO.

~D

         

        
Amy_Lou
on 7/29/12 6:55 am - FL
What a lengthy, insightful reply. How caring indeed!
Thank you, Delores. :)

God Bless you.



';*;'*Amy Lou*;',*; 
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Dolores L.
on 7/30/12 6:13 am - FL
Revision on 08/14/12
You are welcome and I hope it all works out for you.
Sorry for being so wordy   My college English professor said I had a problem with "explainary. " He was SO right!

         

        
Amy_Lou
on 8/5/12 4:31 am - FL
I'm the same way ::giggle::

;)

';*;'*Amy Lou*;',*; 
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