Having both medicare and medicaid and figuring out if they cover weight loss surgery?

• I am disabled and I automatically got medicaid through the state of FL, a coupe months later my medicare became active also...the state pays my part B. I am looking to get weight loss surgery. I went to my primary care and asked for a referral to a surgeon and after a couple weeks of searching one was found. I received the hospital package today that explains everything down a T but I'm curious about qualifying through medicare and medicaid as a candidate. I'm 24 and my BMI is 49. I would figure that they would want to pay for it to possibly eliminate future procedures because of my obesity but I know that not everything isn't that easy or logical. I also read somewhere that medicare only pays for 80% of the surgery...does medicaid pay the remaining amount or does medicaid pay for all of it? If I have both, who pays what? I am enrolled in a health plan with my medicaid and in the booklet there's information on bastric surgeons available in the area...does that mean that they cover it? Anyone ever had the procedure done under these programs? I just anxious to do something about my weight, I've fought with every diet possible and exercise...I need help before I get sicker or die.

• Answer:

  I had caresource (a form of medicaid...) I live in ohio.. I had the verticle sleeve gastrectomy back in august.. 3 days before my 16th birthday... (obviously making it a million times harder for insurance to cover..) my bmi was almost 49 when i started.. (I got it down to like 46 something around surgery day) long story short. medicaid covered my surgery in full. talk to the surgeons office about what insurance's they accept and if you qualify with them then after whatever process they have you go through they'll submit for insurance approval.. and even if it doesn't go through the first time, they can appeal... i've heard a lot of stories of insraunce companies covering peopel just to shut them up... haha. www.obesityhelp.com is a great site to check out for more information. I've been a member for over a year now. www.ourfightnow.blogspot.com is a blog i've kept personally about my journey through weight loss surgery if you'd like to check it out. --- also, the booklet that came with your medicaid.. if they list certain surgeons available in the area that usually means those surgeons accept medicaid.. but it all depends on your plan through whatever agency supplies you with it due to disability. ...I know that all sounded extremely confusing. basically the best way to find anything out is to call the number on whatever insurance card(s) you have, and talk to whatever surgeons office you are planning to go to, and ask all these questions. its different from person to person, state to state, office to office, etc.. good luck. (: