Okay, this is gonna be long.  You've been warned!  My original doctor finally returned my call.  I told him about my issues with his staff.  He said he'll address it.  Yeah, sure.  So, the story is this...My insurance is Medicaid.  Please don't judge me.  You have no idea what my life has been like.  I never thought I'd end up on SSI and using Medicaid.  Well, if I paid cash for the band, Medicaid would not be responsible for any follow-up care.  If I had slippage or erosion, I'd be stuck paying for anything out of my own pocket.  My doc also said that he was pretty sure Medicaid would cancel me if I paid cash.  They would consider it a resource.  He could be right.  I don't know and can't take the chance.

He suggested I call one of the docs within the same hospital group.  I did and it sounded good.  Then I found out that they only accept a certain type of Medicaid.  Not mine.  Okay, I give up.  No band for me.  I could go to Mexico and pay cash.  But again, what if I need follow-up care?  I'm totally bummed.  I call Medicaid again.  I'm number 12 on the list on hold.  Note to self:  Do not call Medicaid during the first couple days of the month.  Again, I ask Medicaid for docs in my area who do bariatric surgery.  They're gonna send a list.  Nice.

After my wog in the pool, I call HOAB, the place that has the seminar tomorrow.  I question them repeatedly about the Medicaid issue.  They said I'd have to sign a waiver but there would be no problems.  They offer lifetime fills and follow-ups.  Of course, that doesn't include slips or erosion, etc.  I then Googled for other docs in my area.

I FOUND ONE!  It's not an ideal location.  I'm not thrilled about the program.  But, I can make it work.  I don't know if I'll have to do a 6-month doc-supervised diet or any of the other stuff.  I will have to have a psych eval and I'll self-pay that.  They have a 25 page packet on their website.  S is printing it at work and I'll fill it out and fax it back.  I don't have to attend another seminar...yipee.  Beyond this, I know nothing.  If this doesn't work out, I'm done.  I'll know that this is not meant to be.  I told S that we'd just make a suicide pact if this doesn't pan out.  That, or move to an island and eat coconut 'til we die.  Wonder if we'd have to take The Parent People with us....

I'm totally conflicted.  I've been so up and so down.  I'm afraid to call Medicaid again and see what other obstacles I may have to deal with.  I can do the 6-month diet.  But not on my own.  It'll be doc-supervised.  I will not diet on my own again.  Skip ahead, pack on forty pounds in addition to what I might have lost on the diet.  Hell, I'll just pack on the 40 now and skip the fun of the diet.  Geez.

Now, I'm gonna research this new surgeon.  I'm scared.  If there's anything wrong, I don't think I can handle the disappointment.  This has been so hard.  A good thing though is that my original doc said I was a great candidate for lap band.  I'm so prepared I could lead a freaking seminar myself.  He also said that while losing weight may help with my back, it may not.  If I lost my Medicaid, then I'd be totally screwed if something else happened.  He had a valid point.  So, I'm not gonna report him to the Board of Healing Arts.  Although I'm not sure I agree about Medicaid dropping me if I self-pay.  I did self-pay my neurosurgeon and will be paying him for the rest of my life.  No one had a problem with that.

I want to comment on the conflict with having cash to pay for a surgery when I have Medicaid.  S won a settlement.  It's money from that that would have been paying for the band.  S fought a long, hard battle and absolutely deserves every penny she received.  She was going to pay for my surgery out of the goodness of her heart.  She could have chosen to pay off credit cards or something else.  But she made a selfless choice.  I don't feel that her money should be considered a resource.  If I lose weight, I probably won't need all the medications I currently take.  That would save Medicaid some money.  But, that's not how it works.  This has been a hell of a day.  I'm just now drinking a protein shake.  It's 5 pm.
My fingers are crossed.  I'm praying and offering it up.  I don't know what else to do.  What will be, will be. But I really, really can't take any more disappointment.  I want a band.  I want to be thin, happier, healthier.  This post seems to have gotten long and boring.  Sorry.  I think I'm just rambling.

1 comments:

Beth said...

Could you call Medicaid anonymously and ask them what their policy would be if somebody gifted you the money to self-pay?

And as far as the 6-month pre-op, that's totally dependent on what insurance requires. Maybe check on LBT and see if anybody else has used Medicaid and what they were required to do. I'm going on the assumption that the rules would be the same across the board, but now I remember that Medicaid is run at the state level, no?

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