Medicaid to be cut off 8/31

[PSquared_vsg 68]

So, I recently went to see Dr. Vadim Gritsus about getting the sleeve done. I currently have Horizon NJ Health through NJ Family Care (medicaid) but I'm being cut off at the end of the month because my income is now over the limit. NJ Family Care suggested purchasing insurance through the Marketplace. That being said, I'm wondering if anyone knows of an insurance plan offered through the marketplace that has a 3 month or less requirement process for bariatric surgery. I've considered quitting my job in order to keep the medicaid but its just too drastic and I'd rather do the right thing and purchase insurance (the insurance through my job doesn't cover bariatric surgery).My BMI is 41 and I've already been told I qualify.

[GreenTealael 24,875]

Fidelis, check if the surgeon and hospital accepts it

[ARMoma45 353]

9 hours ago, doublepau said:

So, I recently went to see Dr. Vadim Gritsus about getting the sleeve done. I currently have Horizon NJ Health through NJ Family Care (medicaid) but I'm being cut off at the end of the month because my income is now over the limit. NJ Family Care suggested purchasing insurance through the Marketplace. That being said, I'm wondering if anyone knows of an insurance plan offered through the marketplace that has a 3 month or less requirement process for bariatric surgery. I've considered quitting my job in order to keep the medicaid but its just too drastic and I'd rather do the right thing and purchase insurance (the insurance through my job doesn't cover bariatric surgery).My BMI is 41 and I've already been told I qualify.

I'd reduce my hours to keep the medicaid. I have private insurance and i've paid close to $4500 out of pocket so far.

[New&Improved 1,780]

I'll be paying $4000 just for surgery/ private hospital stay also..

[PSquared_vsg 68]

4 hours ago, GreenTealael said:

Fidelis, check if the surgeon and hospital accepts it

I will check! Thanks!

[PSquared_vsg 68]

4 hours ago, ARMoma45 said:

I'd reduce my hours to keep the medicaid. I have private insurance and i've paid close to $4500 out of pocket so far.

I am actually considering this. I'm just not sure what they'll ask me for... a paystub? and if so, I won't have on that displays a reduction in hours until next Friday Aug 23rd. I guess I'll call and ask what would be required if I"m expecting my hours to be cut.

[PSquared_vsg 68]

3 hours ago, Mikeyy said:

I'll be paying $4000 just for surgery/ private hospital stay also..

wowww, not including doctors/specialist visits I assume.

[Midnightsun 129]

15 hours ago, doublepau said:

So, I recently went to see Dr. Vadim Gritsus about getting the sleeve done. I currently have Horizon NJ Health through NJ Family Care (medicaid) but I'm being cut off at the end of the month because my income is now over the limit. NJ Family Care suggested purchasing insurance through the Marketplace. That being said, I'm wondering if anyone knows of an insurance plan offered through the marketplace that has a 3 month or less requirement process for bariatric surgery. I've considered quitting my job in order to keep the medicaid but its just too drastic and I'd rather do the right thing and purchase insurance (the insurance through my job doesn't cover bariatric surgery).My BMI is 41 and I've already been told I qualify.

I would definitely speak with hr and see if they would cut your hours so you qualify for now. Unfortunately, the way things work if you pay for insurance you will be using a lot of your pay to cover the premium. Do what you need to do for yourself and your health. I have BCBS thru my husbands union and there actually isn’t a wait period with them anymore. I had very minimal copay. I think around $300 or so not counting the $20 copays here and there for dr. visits. Although, my surgeon had a wait period which actually was good in getting adjusted to the changes. If you find one that covers it check the copays too. Good luck to you, wishing you the best.

[ARMoma45 353]

17 hours ago, doublepau said:

I am actually considering this. I'm just not sure what they'll ask me for... a paystub? and if so, I won't have on that displays a reduction in hours until next Friday Aug 23rd. I guess I'll call and ask what would be required if I"m expecting my hours to be cut.

They should also accept a letter from your supervisor saying that your hours have changed. Otherwise it'd be a check stub. A coworker of mine is going through this with her medicaid...she's pregnant and didn't want to lose the coverage.

[PSquared_vsg 68]

On 8/13/2019 at 3:40 AM, ARMoma45 said:

They should also accept a letter from your supervisor saying that your hours have changed. Otherwise it'd be a check stub. A coworker of mine is going through this with her medicaid...she's pregnant and didn't want to lose the coverage.

Yes! I've already started the process for getting a status review from NJ Family Care. Now I just have to get the letter from my supervisor to speed up the process. Luckily, I spoke to the receptionist at my Dr's office and she said even if I had a (short) lapse in coverage that they would do everything possible to keep my process going as far as weigh-ins etc.

[ARMoma45 353]

16 hours ago, doublepau said:

Yes! I've already started the process for getting a status review from NJ Family Care. Now I just have to get the letter from my supervisor to speed up the process. Luckily, I spoke to the receptionist at my Dr's office and she said even if I had a (short) lapse in coverage that they would do everything possible to keep my process going as far as weigh-ins etc.

That's awesome😀

[PSquared_vsg 68]

I wanted to give an update! I cut hours at work ad submitted pay stubs to be covered by 10/1 and they made an error on their end in our family size, so i had to resubmit some information to be re-processed. So after two VERY VERY long months, I was finally approved for medicaid coverage starting on 11/1! Durring these two months i paid out of pocket for my weigh-ins ($90 a pop). All I have left to do is see my nutritionist one more time and have my endoscopy done & we'll be ready to submit paperwork! It's been frustrating but worth it!