Medicaid and Revisions

Susan999
on 5/18/14 8:39 am

Does Medicaid pay for a revision?  I have just been diagnosed with severe arthritis and there is a possibility that I may be placed on permanent disability.  I have been fighting years with BCBS about a revision, and now I am fight daily just to work and have a normal life.  I am failing at both.  Every day gets harder and without revision, I know the arthritis will just continue to damage at a rapid rate.  I was just wondering what my chances are of getting a revision if I finally give in to my Dr's wishes and go on Disability with Medicaid?  Anyone have any experience with Medicaid and the revision?

Mary Gee
on 5/19/14 5:04 am - AZ
VSG on 05/14/14

Need more information.........

What surgery did you have?  When?  What is basis for you thinking you need revision?  Are you following plan?  

It doesn't matter whether or not you're on disability - it's medical necessity for revision.  

       

 HW: 380 SW: 324 GW: 175  

 

 

 

 

 

 

 

Susan999
on 5/19/14 6:27 am

I had a RNY by Dr. Facundus in April of 2001.  I only lost 60 lbs. and was promised by him that he would re-vise the surgery if he left my pouch too large.  He continued to give me excuses like I needed to start my family, then I needed to complete my family before he did the revision.  The last procedure he did on me was a scope to check the size of the pouch and he told me that it was not too large and that he was unsure why I was not loosing any weight.  Now he has lost his operating license in my town and moved.  I have since had more tests by another surgeon and they pulled test from as far back as 2004 and the pouch is the same size, so I was mislead about the size of the pouch.  All the records from the original surgery are missing.  I have since gained all my weight back (even with loosing 50 lbs with each pregnancy).   BCBS basically said they did not care if the surgery was not performed correctly and they were not paying for a revision.  I have fought this for 3 years.  The pouch was determined to be left 4 sizes to large and the stoma double the size.  I diet non-stop and still do not loose weight.  I am hungry all the time and I was told this would be the case unless there was a revision because the stoma is too large.  I have had second, third, and 4th opinions.

MsBatt
on 5/19/14 7:16 am

Medicaid varies from state to state, You'll need to contact your local Medicaid office and find out what their policy is.

If you get approved for disability, after a waiting period you'll be covered by MediCARE, which is a Federal program---and yes, MediCARE does cover revisions.

In the meantime, you need to be researching the various kinds of revisions. I personally would recommend you concentrate on revising your RNY to a DS.

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