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Medicaid Guidlines For Revisions To Vsg ? Anyone Know What They Are ?

I applied for medcaid today . It seems like i should be approved based on what I have read ? BUT who knows.

Does anyone know what the medicaid guildlines are in Texas for revisions ?

thanks

Mindy

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  • wannarun26
    wannarun26

    then why even post in the first place? that's rude

  • lovealways
    lovealways

    Oh, and for the record...ignore rude comments from rude people

  • coltonwade
    coltonwade

    Well first off dont assume things before you ask ... My band is severaly messed up !I can no longer get fills due to scar tissue from slips and the opening to my stomach would be closed off if I were

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gonna keep my opinion to myself

According to the Medicaid website it varies by state but it really boils down to the first surgery and if it is causing you problems. If you are having complications and need the revision to save your life then I'm sure your surgeon will work with Medicaid to get it approved. However, there are tons of people on this forum who do not have insurance or have a weight loss exclusion on their insurance policy or simply can't afford it and are saving to be able to get there. I understand the need for Medicaid but for reasons other than WLS.. If the revision will help save your life, co morbities, bad lap band, etc. then I truly hope this works for you =)

  • Author

Well first off dont assume things before you ask ... My band is severaly messed up !I can no longer get fills due to scar tissue from slips and the opening to my stomach would be closed off if I were to get afill. I throw up daily, i can no longer eat most solid foods and live on liquids, I am 20 pounds from my original pre surgery weight of 250 pounds and that was AFTER losing 125 pounds with the band originally .

I also have other issues I never had before the band such as severe fatigure, joint pain, muscle aches, cold hands, cold feet, numb hands , numb feet , just to name a few !

So I dont know if that means i need it to "save my life" I am also trying to save for the surgery ..

Well first off dont assume things before you ask ... My band is severaly messed up !I can no longer get fills due to scar tissue from slips and the opening to my stomach would be closed off if I were to get afill. I throw up daily, i can no longer eat most solid foods and live on liquids, I am 20 pounds from my original pre surgery weight of 250 pounds and that was AFTER losing 125 pounds with the band originally .

I also have other issues I never had before the band such as severe fatigure, joint pain, muscle aches, cold hands, cold feet, numb hands , numb feet , just to name a few !

So I dont know if that means i need it to "save my life" I am also trying to save for the surgery ..

I apologize if my post came off rude, that was not the intention, I promise. My reply was simply an answer to your question of whether or not the revision would be covered. I have worked in the medical billing business for 20+ years and so I know how Medicaid handles things. They are the worst "company" out there. They take forever to pay, make up reasons to not cover things and their fee schedule (what they pay) is the absolute lowest in the market. Medicaid, according to their own page, left the verbiage open to say that they would cover it IF there were horrible problems with the original surgery. That is why I used the term "save your life", simply to let you know how they would handle it. They may cover it if you can get your surgeon to fight for medical necessity based on the horrific problems you are having! I just had the surgery in Mexico because of an exclusion on my policy and while there met a woman who was having a revision from the lap band the same day. They had to cancel the sleeve part of the surgery because her band had eroded her stomach so badly that the sleeve would not have healed correctly. The staples would have fallen out because her stomach was so "mushy" per the doc.

Anyway, please accept my apology for maybe saying things the wrong way, it was not my intention.

Good luck with your journey =) I hope you can get that band out

  • Author

I was directing it more towards the other person , I have been attached and attached more in the last few days since I am being more " open" about my band issues than I have in my ilfe all for simply wanting to eat and be normal again .

I have worked in the medical field and I understand they take forever and all that " good stuff" But Its the only option I have right now . There is no way I can save enough money for surgery ... even the PCIP Insurance that I could get I can afford to get its $300 a month for just me. I dont know what else to do . I cant live like this anymore. I really cant.

Have you checked into Belite Weight? they were able to finance my surgery for me and made it possible. I would have never been able to get it done without them! My payments are really low and I had a fairly small down pymnt to make. My doc was in Juarez but the hospital and staff were amazing and I'm having a great recovery. If your band is giving you that many problems they may need to just take it out and let your stomach heal before doing the sleeve =(

I was directing it more towards the other person ' date=' I have been attached and attached more in the last few days since I am being more " open" about my band issues than I have in my ilfe all for simply wanting to eat and be normal again .

I have worked in the medical field and I understand they take forever and all that " good stuff" But Its the only option I have right now . There is no way I can save enough money for surgery ... even the PCIP Insurance that I could get I can afford to get its 300 a month for just me. I dont know what else to do . I cant live like this anymore. I really cant.[/quote']

Your health is most important and a number one priority. I hope it's covered fully for you. It's not like your asking for implants to be covered...lol...but a medically necessary surgery. Good luck to you :)

  • Author

Have you checked into Belite Weight? they were able to finance my surgery for me and made it possible. I would have never been able to get it done without them! My payments are really low and I had a fairly small down pymnt to make. My doc was in Juarez but the hospital and staff were amazing and I'm having a great recovery. If your band is giving you that many problems they may need to just take it out and let your stomach heal before doing the sleeve =(

I have not checked into Belite .. I will check them out , you had a revision done ?

My husband is not very keen on me going to Mexico . At this point he might consider it but its not been an option ..

If Medicaid does not cover it he may .

  • Author

Tonibugg I sent you a message .

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