Re: Medicare/medicaid and WLS

[Guest guest]

Hi Terry;

I don't know about state funded programs, other than Washington and

Oregon... they have a WLS exclusion too... but if he can get on Soc.

Security/medicare/Medicaid I know that they *will* pay for WLS. In fact

when someone is disabled by their weight, as it sounds in this case, they

don't even need to be pre-certified.... just have WLS, then they will pay

the billed costs. (If they are on medicare/medicaid, that is.)

If he's not on SSDI/medicare/medicaid yet, you may want to encourage him to

call Soc. Security right away and get the ball rolling. Have *every* bit of

his medical records and make an outline of *every* problem even remotely

related to his weight. This will help expedite his application.

I hope this helps!

My best;

Jenn in Vancouver, WA

MGB 11-1-00

(The above info is applicable to hospitals/surgeons who are taking

medicare/medicaid patients.)

*****

Subject: Any success with getting state funded programs to get approval?

Hello,

This is Terry Means. I was fortunate enough to have had the surgery

by Dr. Rutledge, and have been very pleased with the results. I am

writing in regard to my older brother. He lives in WV, and is

getting to a 'point of no return'. He is weighing about 530 lbs, and

is getting to where he cannot walk very far any more. The reason I

am writing, is to see if anyone has had any cases that have been

approved by any state Departments of Health and Human Resources. He

has been disabled for several years now because of his weight, and

has been on the welfare system since then.

Have you heard of any successful candidates that have been approved

by this type of medicare, or medicaid programs? (I am not for sure

what he falls under for the medical insurance, he is only 29 years

old.) I have wrote to the department head about this, and she

informs me that the program for the state doesn't approve of any

weight loss practices, including nutrition counseling, medications,

and especially surgery. If you have had any success getting these

type of programs to go through, can you give me some tips on getting

my brother approved. He is really getting helpless, and I don't have

another spare $12,000 to pay for it for him.

I wrote the Department of Health and Resources back, and explained to

them that there has to be exeptions to every rule, and am hoping to

get a response back from them. You know, it is kind of sad to see

him get this big and helpless, but it is even more sad to see the

state watch him die away.

Maybe if you have heard of any special case programs that I might be

able to get to help him get some self confidence back, so that we can

get him on a track of helping himself a little to get him through

these tough times. I really think he is getting to a point where

rational talking with him about his weight loss is not even helping

matters. More of a depressive state, and he is already on an anti-

depressant (at max dose).

I guess I had better stop now, before I start getting more

depressed. I just hope to find some kind of help for him before he

becomes bed rest.

Thanks for being an ear to listen.

Sincerely

Terry Means

tsmeans@...

_________________________________________________________________________

Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

Share information about yourself, create your own public profile at

http://profiles.msn.com.