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Old 01-14-2006, 10:49 AM   #1
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Join Date: Jan 2006
Posts: 1

Question newbie help with surgery on Medicare

I am a 34 almost 35 year old newbie to the board. My doctors have all recommended surgery for me I'm 5'5 400lbs+ (well over that). I am on Medicare and have run into a brick wall of sorts. None of the doctors want to deal with me because I am on Medicare and disability. They keep saying that they can't afford to eat what Medicare doesn't cover. So I am caught in a catch 22 my GP doctor has been very straightforward and has tried to direct me to assistance but I fall in that catagory of unable to get financial aid loans for the surgery and Medicaid won't step in because I make about $100 over their maximum 600 monthly income level. I feel lost which of course only makes me end up mindlessly eating more out of frustration. I'm not making excuses I know that I am responsible for every morsel of food that has brought me to the state I am in, but as I told my doctor I just can't believe that I am the only low income person on medicare to need and gastric bypass surgery. If it was then Medicare wouldn't even cover any of the surgery. Does anyone know where else I might turn for help? Even our local university hospital has decided that GBSurgery was too risky to do anymore... Thanks
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Old 01-14-2006, 12:48 PM   #2
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Location: Michigan, USA
Posts: 295



Not much time right now- but I might be able to help with some ideas. You are in the US, rignt? You're on SSDI & your monthly amount is a little over the amount to qualify for Medicaid? Other then the amount of your monthly SSDI payment, do you otherwise qualify for Medicaid finacially (ie- not over $2000 in the bank, IRA, retirement fund; only own one car, own one house that you live in, etc?). How much do you spend per month now on medical expenses that Medicare doesn't cover?-ie: drug copays, doctor copays, etc? Has anyone talked to you about 'medical spend down' to qualify for Medicaid?

Just to give you a little backgroudn on myself, I'm also 34 & on disability. I recieve SSDI and I also qualify for Medicaid because I pay for in home health aid (its my Mom- and she would be doing it if I paid her or not). If my local Center for Independant Living hadn't pointed me in the right dirrection, I don't know what I would have done these past few years considering my medications were over $5000 per month, plus another $1500-3000 in copay for doctors, durable medical equipment/supplies, labs, procedures, etc.

If you would rather talk privately, you can PM me....
Christine Restarting all over....again...but at least I'm trying
Taking little steps~ 10- 15 pound steps to be exact
1st Step~12/20/05 ~~~ 2nd Step~1/31/06
~~~2/21/06 I've released 10% of my body weight!!!~~~
Now onto Step #3 of 10- Releasing another 15 pounds~
One for each 5 pounds released
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Old 01-14-2006, 03:37 PM   #3
Join Date: Jan 2005
Location: Pennsylvania
Posts: 215


I am surprised Medicaid hasn't covered you; my friend collects both SSI and Social Security disability isurance here in Pennsylvania-$623 a month total and automatically qualified for both Medicare and Medicaid as a result, as well as collected $82 in food stamps. Of course, she only has a life insurance policy as an asset and pays utilities in addition to rent. I would certainly look into the spend down thing or even transfer some assets over to family or a trusted friend.

Your health is very important; hopefully there can and will be other options available to you soon.
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Old 01-14-2006, 07:36 PM   #4
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Scarlet, although I don't have any advice to give, but I would like to welcome you to the board.
Indi ~ Lap RNY 11.18.05

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