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did insurance pay but you still had pay cash?

. Did anyone have Medicaid and not have to pay anything out of pocket? I am in NJ and i found a Dr. The office said they work with all insurances.Which is good news and bad news for me. Now I seen this Dr 9 yrs ago for bypass i never went through with it because they wanted $2,000 upfront because other Dr didn't take medicaid. I really need this so I can be here for my son he will be 1 in July. I can't afford to pay out of pocket. Did this happen to anyone? Was there away around it? Did they just accept whatever your insurance paid? I am just praying everyday I am not denied for any reason I am 27 and do not want a knee replacement this year on in life.. i can barely walk.. i need this more than anything.

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I would check into a things again, a lot changes in 9 years! Your insurance should be able to tell you something, such as out of pocket max. Good luck.

What part of Jersey North or South? I would find a doctor who take Medicaid instead. In Jersey there should be several. Check the major hospitals for their bariatric programs..

  • Author

North jersey both claim to take medicaid... well one said they do but they 1hr away the closer 1 said they work with all insurances... my insursance company when i called had no idea what baratrics was... they kept giving me oncology drs....i know if u have medicaid ur not supposed to hve bills.. but some drs dnt care

  • Author

I would call insurance and if nutrisionst was paid already.. but im pretty sure for insurance purpose you could to a person who took your insurance... and see if insurance took out network dr.... the lady said they do do out of network the dr has to fill out form online or something idk... its hard cu i am not working they did say on site that psych evaluation is 150...

North jersey both claim to take medicaid... well one said they do but they 1hr away the closer 1 said they work with all insurances... my insursance company when i called had no idea what baratrics was... they kept giving me oncology drs....i know if u have medicaid ur not supposed to hve bills.. but some drs dnt care

You could call back and ask about weight management or weight loss surgery. Sadly sometimes you have to spell it out. ;)

If it is a covered service, they can't bill you for it. My insurance covered everything but the nutritionist class. That was $200. I also had a $400 copay for the surgery itself. Other than copays that was all I had to pay out of pocket. I have Keystone 65/Medicare.

If you like the program that''s an hour away, you can save yourself the hassle and go with them. I'm in Philly. I know there are several hospitals in South Jersey that accept Medicaid, but that's probably even further away.

ETA: Often the only non covered services are the psych eval and/or nutritionist.

  • 4 weeks later...
  • Author

I had to switch hmos... but found a dr one city over... greatest news is the psych eval is free because my dad is good friends with the guy and my insurance covers nutrionist or my uncles sistet in law is certified nutritionist... so all i gotnto worry bout is my consult june 23rd... and getting all the test he wants done in a time frame... my dr said he writing a letter for me to insurance because he beleives a 6 monyh diet plan begore surgery will not work.. i have tyroid issue that use mediciation for.. my blood pressures been out there i have horrible knee pain and he said i hve sleep apnea but idk... like i need this to be bettet for my son thata my main focus i wana sit on floor and play and roll round without looking like a fool being hurt or out breath.... drs name is Dr. Jason Garrison in Jersey City Nj

Call your Medicaid worker and ask them. Most people with Medicaid do not have a share of cost.

  • Author

I switched insurances as june 1st every dr is dropping the wellcare insurance 3 drs called offices called 2 say they no longer take it.. but horizon nj health i called and i asked and they said its covered... so i meet surgeon june 23rd... thank goodness... im hoping it goez through this time.....like i dnt give up chicken out or get denied im 369 with sever joint damage in my right knee and my dr says sleep apnea so allz hoping pozitive...

Edited by libbyyum

  • 2 weeks later...

@@libbyyum

Which surgeon in Jersey City? I had Dr. Sebastian Eid from Advanced Laparoscopic in Paramus but they did the surgery at Jersey City Medical Center (which was great by the way).

Surgery itself & the hospital was $500 out of pocket, but pre-surgical co-pays and reports ran me quite a bit.

  • Author

Dr. Jordan garrison.. he works through the carepoint hospitals... his office is next to christ hospital... a family friend told me bout him he does it in christ hospital and takes 1 of the medicaids and stuff... i didnt wana travel crazy i dont have a car ... i meet him june 23rd so im hoping all goes well lol

Dr. Jordan garrison.. he works through the carepoint hospitals... his office is next to christ hospital... a family friend told me bout him he does it in christ hospital and takes 1 of the medicaids and stuff... i didnt wana travel crazy i dont have a car ... i meet him june 23rd so im hoping all goes well lol

I don't know him but my knee surgeon (Dr. Foddai) is in the same building as he is. So was my old GP before he moved. My ENT is in that building too (Dr. Behin).

  • Author

Lol i got lucky everyone i made apt with for last 2 months has droped my insurance... they call bak like nop dont tke it... its very stressful....

  • 2 weeks later...

My surgeon requires $1800 outside of what insurance pays. Every pt required to pay this amount, before you can schedule surgery, to cover the follow-up care.

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