Should Medicare/Medicaid cover the band?

[green 6]

It sucks to be poor enough to need Medicaid. Even if it meant my WLS was paid for, I wouldn't trade with those people. Therefore, I'm not worried that they have it "better" than me in this one area.

I really like this response. I think many of you consider that it is not fair that poor people get away with so many freebies - stuff like medical care, food and shelter assistance - but having money is fabulous. It buys you the freedom to do whatever you want to do whenever you want to do it. I have paid for my own Lap Band surgery and a face lift. I also get to travel in exotic places, live in a nice house, have nice stuff, and eat good food and drink good wine. I pay for it but my life is much nicer, I think.

I also believe that most poor people are not bums but just folk who haven't been in the right place at the right time. In civilized societies we provide the basics for our weakest citizens. We don't like to see 'em perishing in the streets. This is what differentiates our societies here in the west from that of an African tinpot dictatorship.

[carol4784 0]

I'm getting on a soapbox here but I don't think Medicaid should pay for weight loss surgery....UNLESS....the person wanting the surgery is actually working and earning so little that they are still medicaid eligible. It irks the crap out of me that I worked at Child Protective Services for almost 35 years and my insurance when I worked full time excluded WLS. Now that I am "retired" ....my husband and I still work 7/8 time (can't afford not to) our insurance now also excludes WLS. I just believe if a person has not worked or is not working that they should not be able to use medicaid for WLS. I have seen over the last 3 decades clients misuse, abuse the system....some didn't...but why am I working full time and paying for my insurance and then someone who is not working can get free medical care which includes weight loss surgery. The whole system is totally fouled up here. I paid for my surgery out of my $ I earned...problem is medicaid is providing WLS to people who aren't working out of that additional tax money that was hard-earned by me....and many many others. The system stinks. I just don't know why someone who has worked for 35 (now 38) years should have to self pay and someone who has medicaid does not. I paid for the surgery....but I had to work to make the $ to pay for the surgery....it should not be free.

[phowell 0]

I have been on both sides of this. I looked into the band when I was on medicaid. I had 3 small children, lived by myself, went to school for 40 hours a week, did call at night for a little bit of money, and still had to study 20+ hours a week. I did this for 2 years and lived on very little. I was living in subsidized housing and was doing the best that I could. I did not want to "live off the system" for the rest of my life, but at this time I had to have food stamps and medicaid to survive. The state that I was in at the time did not cover lapband with medicaid only bypass and I knew that I did not want bypass. It would mean more time out of school than I could take (I only got 15 days off a year) and I had a friend of mine that did it and I knew it was not for me. So I waited, hoping they would cover it before I made too much money to lose medicaid, but not enough to pay the $485 a month for BCBS for myself per month with the $5,000 deductible that I would have to pay for for a year before I could use it.

Now, I am lucky enough that I graduated from a wonderful program, got a good job, upgraded to a great job in the same hospital and have a good insurance program through the hospital.

Would I want to go back on medicaid and food stamps because it was "easier?" Absolutely not. People look at you in a whole different way when you are on public assistance and treat you like you are lazy and don't want to work. So before you judge, just remember, they may just need a little help until they can do for themselves.

[carol4784 0]

I am not saying that people of medicaid are lazy...it it just not fair....life is not fair that I have to work and pay for my surgery and I have to work to pay taxes to pay for someone else's surgery too. And, the insurance I had at work was not free...I think it cost around $350./mo. I just think there should be a system that in your case you worked....or prove that you are diligently looking for work...and were trying to get off the system....some kind of level....if you're working you should be eligible for more services. In child protective services I supervised clerical staff who worked full time and still were eligible for some public assistance benefits....WIC, medicaid, HUD housing. That's sad. These were people with 2 yr. degrees. When I saw one of them at one of those instant cash businesses that's when I started loaning her $ so she could buy groceries til pay day....but payday lenders...that's another RANT completely. I'd better not get started.

[Jesusislove 26]

Medicaid does cover the lapband in Georgia. Me and another person had surgery the same week, her job would not cover it. She applied for medicaid and got it.

[phowell 0]

carol4784--my point is that yes you pay taxes and work--good for you! You do that in case, at some point in your life, something should go wrong and BOOM!! You find yourself needing some sort of state assistance. I worked, was married to an enlisted military man, and paid taxes. Then, he decided that he was going to drink our money away, stay at other women's houses, pay for their cars, and sleep in their beds. I left. It left me with no money and no career because I stayed at home and worked small retail jobs for little pay around holidays because he was supposed to take care of me (or so I thought). I didn't go to school like I should have--my first mistake. So then I was stuck with him not paying child support, a car payment, and a job that paid a little over 200 dollars a month! Yes, there are people that take advantage of it, but you can't punish the people that really need it because of them. It is definitely not a black/white situation!

[WASaBubbleButt 41]

I find this funny, cause this is exactly how health insurance works. Everyone pays into health insurance and only some have to use it. I could pay thousands of dollars in my lifetime on health insurance and never use it once.

The only difference between the two is one is government ran and the other is privately ran.

Not really, in one case it is voluntary payments to purchase health insurance and in the other it is taken from us without our approval so OTHERS are covered for the same procedures many of us are not covered.

Not the same, not the same at all.

[ingyrob 1]

What about me then? I pay into a Private Insurance Sheme and into the National Health Service and I still had to self pay for my band. And I met the criteria for the NHS. I am envious of those who get it for free, especially those with a much lower BMI than me.

[sistasassy 6]

I think one of the respondants earlier hit the nail on the head. There are a number of working families out there with no insurance and no way to pay medical. My husband and I have 5 children between the two of us. We are both working full-time and have no insurance EXCEPT Medicaid. Neither job offers insurance at all. Should I therefore be punished and unable to have my surgery?

For many years I paid taxes and had insurance. Now I do not. I refuse to feel belittled and like poor white trash because we are only on Medicaid.

The thing people forget is that Medicaid is for working families too. Not everyone is freeloading off the government. Not everyone is out to cheat the system. I have cheated nothing and still am able to have my surgery and will not let anyone take away my joy at the prospect of a future of feeling better, a future of seeing my children grow, a future of . . . life.

[WASaBubbleButt 41]

I think one of the respondants earlier hit the nail on the head. There are a number of working families out there with no insurance and no way to pay medical. My husband and I have 5 children between the two of us. We are both working full-time and have no insurance EXCEPT Medicaid. Neither job offers insurance at all. Should I therefore be punished and unable to have my surgery?

For many years I paid taxes and had insurance. Now I do not. I refuse to feel belittled and like poor white trash because we are only on Medicaid.

The thing people forget is that Medicaid is for working families too. Not everyone is freeloading off the government. Not everyone is out to cheat the system. I have cheated nothing and still am able to have my surgery and will not let anyone take away my joy at the prospect of a future of feeling better, a future of seeing my children grow, a future of . . . life.

I think I have to change my vote. I originally felt that Medicaid should cover WLS. But after this post of "entitlement" I realize that there are many who save money for surgery. Like me... twice.

[sistasassy 6]

Whatever. You can choose to read my post in a negative manner I suppose.

You have accomplished something great is saving for your surgeries. I wish I could have done the same. Congrats on how well you have done!

[terilynn112 1]

I think one of the respondants earlier hit the nail on the head. There are a number of working families out there with no insurance and no way to pay medical. My husband and I have 5 children between the two of us. We are both working full-time and have no insurance EXCEPT Medicaid. Neither job offers insurance at all. Should I therefore be punished and unable to have my surgery?

For many years I paid taxes and had insurance. Now I do not. I refuse to feel belittled and like poor white trash because we are only on Medicaid.

The thing people forget is that Medicaid is for working families too. Not everyone is freeloading off the government. Not everyone is out to cheat the system. I have cheated nothing and still am able to have my surgery and will not let anyone take away my joy at the prospect of a future of feeling better, a future of seeing my children grow, a future of . . . life.

AMEN!!!!!!!!!!!!!!!!!!

I get NY medicaid and Medicare because I'm disabled. I live in daily, chronic horrible pain. My dr's think if I loose weight it may help. We won't know for some time yet. But if it might help, I'll do it. I would give anything to be able to return to work. It's been many years, and truthfully I hate living on the system.

And here in NY medicare pays for fills... 80% like other items... and medicaid will pay the rest.

terilynn

[Jesusislove 26]

Hi, government spend ridiculous money on everything else, why not WLS? I believe that WLS not only improves people's health, but it improves how they see themselves. I believe when you see yourself different it will help you become a better person. For the ones that do not work, I believe that sometimes weight can be a hinderance to a person's outlook on life. If you work, no doubt about it, if you can get Medicaid, then use it.

[Guest jada1985]

I'm glad they do. That's how I got it. Another good point is that the rest of the insurance usually eventually follow suit when medicare does something . Sharon

Im going to try to apply for medicaid. im at 53% bmi and am sure I will get a md recommendation. Do you mind if i ask what you have medicaid/medicare for?

[surfergirl 0]

I have them both and they pay 100%

t=rose