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Has anyone got around the 3 year supervised diet with Nevada medicaid? If you have gotten around it how?
When I was offered my new job I hesitated accepting the offer because I was so close to getting my RNY. All my pre op testing was done it was just a matter of working it in my schedule. My family made me feel silly for even considering not taking the job. Well I'm 3 months in and found out bariatric surgery is excluded from or policy. To say I'm bummed is a huge understatement. Im a single mom so I can't look to a spouse's insurance. We had medicaid but im pretty sure I don't qualify now with 2 jobs, especially since my job offers free insurance to employees.
Consider this a vent. The thought of paying out of pocket hurts my soul. So idk how to regroup or what to do. Any tips on what worked for you or guidance will be greatly appreciated.
~k
RNY T.B.A.
http://TheeDownsizingDiva.blogspot.com/
Your insurance rep is trying to help you. Do you think that she has no idea how insurance companies operate? If this is a covered procedure that they are likely to okay after six months of an approved diet/exercise program, the worst that can happen is that your insurance company will insist on the full six months, which you were expecting anyway. So it's not like you'd be any worse off for giving your insurance rep's idea a shot, and you might get your procedure sooner than you expected. JMO.
Race is not a factor in terms of qualifying for Medicaid, and the worker who told you that was unprofessional at best. You can't be denied Medicaid if you are eligible. You should have received a written denial which cited the specific reason(s) for your ineligibility for Medicaid and which provided information on how to appeal if you disagreed with their decision, and you should have appealed. This is the correct procedure, but it doesn't sound like it was followed. If that's the case there's very likely no record that you even went to the welfare office, let alone talked to someone about your situation. You received a pretty obvious clue that things were not proceeding correctly when that worker told you that you'd have received benefits if you were black or Mexican, and you took the bait. Next time, ask for an outrageous and illegal statement like that to be put in writing, and watch how fast gears start to shift.
As for ObamaCare, I hate to break it to you, but it doesn't cover WLS. No plan purchased through the Marketplace covers it, not even the most expensive plan, not even if you forgo any subsidy that you're eligible for and opt to pay the full premium. You (general you) would have to purchase a plan directly from the insurance company of your choice after determining that it will cover WLS. And you should also be prepared to pay top dollar for it. Yes, it stinks, but if you need to hate on someone, hate on the profiteering insurance companies and the people who think success at weight loss is merely a matter of will power and and strong personal morals -- unless you've got bucks, of course.
However, even though it won't help you with WLS, you should be eligible to get a plan through ObamaCare. You would have to document your ineligibility for Medicaid, though, and you would also need to show some income. If you live with your fiance, you can give his income information and note that this is for a household of two. If he gets insurance through work, note that and also note that this insurance is not available for you. You should qualify to buy a plan through the Marketplace and to receive a subsidy as well. While it won't cover WLS, it will cover other stuff like proper treatment for PCOS (which might help your weight loss efforts), not to mention proper treatment of your other health issues.
The open enrollment deadline has passed, but it would still be worth a call or visit to Healthcare.gov to see if they can help you before open enrollment returns in October. There were reports on national news indicating that there were some situations in which people could get extensions to enroll and yours might be one of them. There are also various agencies in each state which have workers called navigators to help people who are having trouble making their way through the process. You should be able to find out more about navigators in your area at Healthcare.gov.
Good luck!
well, the Affordable Care Act and Medicaid are,obviously,two different things.
one of the high points of the ACA is that no one can be turned down. For people who can't work,there are subsidies offered to help with the premium costs. Some ppl who have very limited income re receiving free policies.
I don't see any reason at all that you can't get insurance through the ACA.
Unfortunately, the enrollment period for this year ended on March 31. I believe the next sign up is in October.
Many people have one car and still share the car for work. You can also work from home. Many of us had to switch insurance many times before we were covered.
Vsg on 8/6/14 5'8" HW 266 SW 243 CW 169 GW 155. 
on 4/2/14 2:44 am - Margate, FL
I'm sorry you're having such a hard time getting help with insurance. However the aide's comments to you were incorrect. Medicaid is a state funded program that doesn't discriminate. Unfortunately there are criterias that must be meet with either Medicaid or ObamaCare & race isn't one of them. I'd contact a supervisor bcuz the aide gave inaccurate information maybe he/she was wrong with your case. I wish you luck on your journey
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I have been without insurance for the better part of a decade, relying mostly on free health care provided by donations and volunteers. I worked for 7 years at a financial firm in Nashville Tennessee and in that time, they did not offer me health insurance one time because in part I was a full time temporary. And being overweight I couldnt afford the High Risk insurance in Tennessee because it was $600 a month for me for being overweight.
Once Obamacare was hinted at, I was like FINALLY I will have insurance. Well.... No such luck. I applied with the state of Ohio which I currently now live and have lived for 3 years. I dont have a job or a way to get to a job now. Being that my fiance uses the only car we have to get back and forth to work every day that is an hour to and from. I applied for Medicaid and The reply from the state was "Even though Miss. Smith, you do qualify for Ohio Medicaid, we are denying your application. When I contacted the office. They said come in and talk with us and we will see what we can do for you.
I get there and the aide that was helping me asked, very simple questions, 1. Are you pregnant (No I cant have kids) 2. Are you an unwed mother (Again no, I cant have kids) 3. Do you have a job making below poverty level wages (No, I have no way of getting to and from a job so I make no money and am under the poverty level) 4. Are you of African American or Latino descent (No Im Caucasian).
They said because I answered no to every question, that I was being denied because the government deemed me non sufficiently eligible. I even gave them past health records to show the need for the help. I have PCOS (Poly-Cystic Ovarian Syndrome) High Blood Pressure, Asthma, High Cholesterol, and had a mini Stroke. Which I require very expensive medications every month and I need help getting them.
The exact words next literally made my jaw hit the floor, they aide, pulled me to the side and said and I quote "If you were black or mexican you would have health care no problem"
I was floored by this comment.
I cant get medicaid, I cant afford Obamacare. Even the cheapest plan is out of my price range of $349 a month. and thats the basic plan that only covers Medicine, Office visits and thats pretty much it.
I give up, I will never be able to get weight loss surgery to save my life. I walk every day. I eat right and they weight wont come off. I need help and insurance. But, the government doesnt care about me. I dont even matter enough to be counted as in the poverty level and get assistance.
I'm going to die because I cant get help from the so called President that says he is helping everyone.
Sorry for the rant, Im tired of being tired and sick. And when I seek help, I just get a cold shoulder.
on 3/31/14 11:30 am - Margate, FL
Congratulations on getting approved & much success on your revision
Hockeymom87 · 0 replies · 728 views
