Next Step - Help, Please? (Sorry for the long post!)

Elena Ramon
on 12/9/14 6:40 pm - Chicago, IL

Hello everyone!

I'm so glad to be a part of this website. I actually joined a couple of weeks ago, but life kind of got in the way, so I haven't done anything with my profile until now.

Here's my question. I've been looking into getting WLS for over a year now. My journey started in March 2013, when I had my gall bladder removed. My surgeon spoke to me about WLS because I'd been morbidly obese for so long and my health was obviously starting to deteriorate. I was 20 at the time of the conversation so having it soon was a bit intimidating. I didn't want to give an outright yes, I wanted to know more about what it was like to have and live with WLS in the short term and long term.

But before I could every start the actual process two important things happened:

1) My surgeon died in an accident and I had spoken to no one else about the possibility.

2) My college health-insurance ended after I graduated

 

However, I didn't want this to stop me. I kept learning about WLS and talking to people who've uploaded their stories onto YouTube or who have friends in common that could introduce us. I'm convinced now that I do want WLS and that I've prepared myself as much as I can.

I didn't have a PCP or clinic by that point anymore, (the gallbladder was an emergency hospital visit) so I went to the clinic that has seen me since I was a baby. I spoke with the Dr there, they looked at my records, and because she'd actually suggested LapBand when I was a pre-teen, she was more than happy to write me a referral.

My problem is now I don't know what to do with it. It's been over a month (maybe 2???) that she gave it to me, but I had to put my search on hold because my mom had surgery about a week after I got the referral and I was the one to take care of her. She's better now, so I can continue my journey. I digress...

I applied for Cook County Care in the mean time, and I received the Medical Card. I don't know what it's called, but it's the one that comes as a piece of paper, it says "Illinois Department of Health". I think it's Medicare. Anyway, I was wondering:

  1. Could I still use the referral even though I got it BEFORE I got the Medicare card and I paid cash for the consult.
  2. Do I need to get a new referral and use the Medicare card?
  3. If I can still use the referral, where can I go that can start me on the process towards WLS?

I'm a grad student, but I would really like to have the surgery ASAP, if possible before April of 2015. Is that even possible?

Thank you for your time and I await any responses eagerly

        
ChristineB
on 12/10/14 1:24 am, edited 12/10/14 1:36 am - Western 'Burbs Chgo, IL

Congrats on making a decision that will improve your health. I do believe what you have is Medicaid not Medicare. You are not old enough for Medicare unless you are on disability.

I do believe the referral is void due to the time and insurance change since then. You really need to educate yourself on what your coverage is with your current insurance because an informed patient is the best kind. Say for instance if down the line you received a denial for ANY type of medical treatment (not just your future of having WLS) then you would know how to fight for your rights. So, that being said there should be a phone number on your card somewhere - possibly on the back for customer service. Call that number and ask lots of questions. Document who you speak with, date and time plus the context of the phone call. Do not be afraid to call back if you think of more questions. One thing you need to do is have a little more realistic expectations for when might be able to have surgery. You might have to wait to get an appointment with a doctor that is within your plan and then there is pretesting (psychological and medical) before they can even place you on the surgery schedule.

Hope this helps.

 
Open RNY May 7
260/155/140 




 

Elena Ramon
on 12/10/14 3:00 am - Chicago, IL

Oh, ok, yes that makes a lot more sense. Thank you for replying so quickly!

I was only confused because the card came out of the blue instead of the Cook County Care that I had applied for initially.

April was my fantasy month to have WLS, but that was considering a lot of things happening quickly and positively; me being able to use the referral, for example. Of course I don't care how long it takes before I would get the surgery, the process alone is going to help me become healthier anyway so it's not like I'm losing anything.

Thank you for your advice. You're right, I have Medicaid, HA!, I did check. That being said, do you recommend somewhere I can begin my search for a new doctor? Or would I still be able to go to the Doctor I went to before, just getting a new referral?

        
ChristineB
on 12/10/14 3:03 am, edited 12/10/14 3:14 am - Western 'Burbs Chgo, IL

Sorry, I am not familiar with Medicaid doctors. Again, try and call the # for customer service and see where they can get you started.

Just did a Google search for Medicaid doctors chicago and a lot of links popped up.

Also, there should be a website for your program. It might be on your card. Look in your paperwork for your member handbook. If you do not have one then contact customer service and request on.

 
Open RNY May 7
260/155/140 




 

ChristineB
on 12/10/14 7:20 pm - Western 'Burbs Chgo, IL

Come join us in the daily roll call. We love to meet new people.

 
Open RNY May 7
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Elena Ramon
on 12/10/14 7:27 pm - Chicago, IL

What's that entail? I haven't even started the real process yet :(

        
ChristineB
on 12/10/14 9:04 pm - Western 'Burbs Chgo, IL

Look in the list of posts for the IL forum and you will see a post that will be for the current day. We come in and share what is going on in our lives. You do not need to have had surgery already. There are a bunch of us from across the state that share and support others.

 
Open RNY May 7
260/155/140 




 

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