Getting Medicaid to pay for your surgery

Hi there

The Brooke Ileostomy is, in fact, the 'regular kind with the bag' - It's named after UK surgeon, Bryan Brooke who perfected the technique of making a stoma that actually worked properly. Perhaps, you're talking about the j pouch instead (an internal pouch where you don't have to wear a bag?)

I can't help you with your insurance questions since I don't live in the US, just wanted to clarify the above for you :)

PS. The Brooke Ileostomy may be cheaper to perform (I'm not sure) but the long term costs, ie the bags and stuff may outweigh the cost of actually having j pouch surgery which may be a point to bring up to the insurance companies.

Good luck.

When we applied for food stamps and Medicaid, they said we make too much money to get Medicaid, but enough money to get the share of cost plan. We live in Florida, I don't know if this program is everywhere. We applied through the department of children and families, in our state we were able to apply for benefits online, then they send you a letter asking you for your proof of citizenship and state residency and income for the last 4 weeks. The process is sometimes very annoying getting all that stuff together (they make you prove *everything* again every few months) but we go through it anyway!

And shaz you are totally right of course, I had to smack my husband for swearing to me on all the terminology being right, and smack myself for just trusting him and not checking on it lol He said now that the one he wants is the Koch pouch (hope that's right), should be the one you put a valve in to empty.

BTW for all interested, I spoke at length to a person from Medicaid today, they said that we have to find a surgeon who takes Medicaid, and the hard part will be convincing that surgeon that Nathan has the medically needy program because there is not medicaid #, and you aren't in a computer anywhere, it's like you don't exist in their system at all if they try to look you up, so the surgeon basically has to take your word for it that you have medicaid share of cost and give you their surgery and THEN create the bill and send it to medicaid. The medicaid representative said it might be difficult to find a surgeon willing to take that risk. Also, once you find a surgeon who will trust you that much, certain surgeries need authorizations and the surgeon has to fill out a request for a special surgery and get it approved with the Medicaid main office before surgery. Sometimes the surgeon also has to do a "keypro" authorization so the hospital can get paid as well, which also has to be done before the surgery, or medicaid won't pay for it.

It sounds pretty complicated getting medicaid to pay for anything in this situation but we're going to try our darndest, I got the phone number of basically one surgeon who takes medicaid, which is pretty scary that we really don't get to pick a doctor based on credentials, but on whether they take medicaid. Nathan found online that patients having their colostomy surgery performed by Medicaid surgeons have a higher mortality rate.....how reassuring!

icepixycicle
Back in 1993 when my husband was very sick with Crohn's Disease and I was pregnant with our last child. I was only making 6.00 a hour and went down and applied for medical coupons with DSHS and the in 1994 they did pay for his surgery. But I'm having to fill out paper work for charity this time at the University of Washington, we have insurance until the end of March. Because he's been out of work for 3 months and ran out of sick leave and vacation. His job is a great and they are asking co-workers to donate their sick leave for him that's why we will have insurance until the end of March. This will be his third surgery. I was thinking about just applying for Medical coupon again. But I'm not pregnant and can't get pregnant. I also took a looked at our basic health here with the state and they don't cover pre-existing for 9 months so that don't work for us. Well good luck and I think our states medicaid cover for the wrong reasons sometime. The only time you really can use them is if you are pregnant. We have a long road ahead of us to get my husband back on his feet and back to work. We also are waiting for is Long Term Disability to kick in but it doesn't pay as much a his regular pay. And I haven't work because he need 24 hour care. Do you know if there is help for having to take care of your spouse or family member?
Good Luck,
Dancerpeg