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Insurance Question?

I haven't been to my seminar yet, but already I am worrying about out of pocket expenses. I have medicare A&B and medicaid medicare, I know medicare pays 80% but I am not sure about medicaid medicare and if or what they will pay. From my understanding they are supposed to pay what medicare doesn't. I do not know how this works or if that is true. I live in Indiana, can anyone help me understand? I am so afraid I will not be able to afford this as my only income is SS. I am getting myself all worked up and have not even been approved yet, my goodness! Was anyone else as nervous as I am in the beginning of the process?



Glojia



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First of all welcome! I know this is a hard process but it's going to be worth it in the end. You should call your insurance and ask what all is covered, it may be more than you think. Also the benefits coordinators at your surgeons office are a great resource.

Hope some of this helps.

PS What part of Indiana are you from?

  • Author

Hi ShirleyJ84, thank you for replying. I live in New Castle. Yes I will talk to the benefits coordinator, I am just nervous and worried because I do not understand everything. I am sure when I go to St. Vincent Carmel, I will get my questions answered, I am scheduled to go to a seminar in a couple of weeks. I just have to be patient I guess. Again thank you for replying.

I'm also using St Vincent Carmel. Wonderful organization. Do you know who your surgeon is going to be yet? Have you started your 6 month diet?

  • Author

I am just starting out and go to my first seminar in August. I know a Dr. Diaz will be the surgeon conducting the seminar that I will be attending. Would he be the surgeon who hopefully will do my surgery? I really wish I was at the diet stage, that would mean I was another step closer. No, I am just getting ready to begin.

The doctor that is doing the seminar is usually the one who you get, at least that's what they tell me. All the doctors are great there. It's never too early to start the pre op diet. They have a doctor you can work with at their center you can work with or your own doctor. Good luck on your journey and if you have any questions feel free to ask. This is a valuable site full of lots of support.

I am also on Medicare and Medicaid (Pennsylvania) Was informed by Docs office that there was no deductible or copay for my surgery. There was a $350.00 charge for the nutrion classes, books etc.

  • Author

So I called the medicaid coordinator and found out that I am enrolled in the Medicare Savings Program. They help with part B premiums, deductibles and co payments for medicare. I am taking this as good news for me and thinking that my out of pocket expenses won't be so bad. This makes me feel a bit calmer. :)

So I called the medicaid coordinator and found out that I am enrolled in the Medicare Savings Program. They help with part B premiums, deductibles and co payments for medicare. I am taking this as good news for me and thinking that my out of pocket expenses won't be so bad. This makes me feel a bit calmer. :)

I have found that the only things I really have to pay for out of pocket was the psych eval and the class beforehand. The eval was 150.00 (I think) and the class is 250.00 (another I think). Those are the only things I was told were not covered.

Good luck on your journey.

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