Jump to content
×
Are you looking for the BariatricPal Store? Go now!

did insurance pay but you still had pay cash?



Recommended Posts

. 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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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..

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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...

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

@@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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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).

Share this post


Link to post
Share on other sites

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....

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×