Hi, I live in Massachusetts and obviously when I heard masshealth covers srs I was ecstatic. But im curious how the process goes? Im almost a full year being full time so thats not an issue. Does insurance cover the whole procedure? Which surgeons ( who are good) accept masshealth? Im asking this cause i told my therapist and she said no ones probably gonna accept it and kibda shot the idea down :/

Most of the SRS surgeons require their fee to be paid upfront, and will work to get you reimbursed by your insurance afterward. I have Aetna and only found two that are in network. your insurance should cover the hospital and anesthesiologist cost.  I think some surgeons take insurance other than what I have.  I had to contact the Doctors offices and inquire, because usually they don't have that information on their websites.
I know, it is frustrating! having coverage, but still having to pay upfront is almost as big a roadblock as not being covered.
Hang in there and good luck!
Brenna

Quote from: BrenB on December 08, 2014, 12:48:49 PM
Most of the SRS surgeons require their fee to be paid upfront, and will work to get you reimbursed by your insurance afterward. I have Aetna and only found two that are in network. your insurance should cover the hospital and anesthesiologist cost.  I think some surgeons take insurance other than what I have.  I had to contact the Doctors offices and inquire, because usually they don't have that information on their websites.
I know, it is frustrating! having coverage, but still having to pay upfront is almost as big a roadblock as not being covered.
Hang in there and good luck!
Brenna

Thank you Brenna! But I was curious maybe its possible to take out a loan to pay for the upfront fee and then have the insurance pay off the loan debt? Idk I just got so excited that I guess I never read the fine print.

Quote from: ali.yo1991 on December 08, 2014, 07:09:29 PM
Thank you Brenna! But I was curious maybe its possible to take out a loan to pay for the upfront fee and then have the insurance pay off the loan debt? Idk I just got so excited that I guess I never read the fine print.

That's a really good idea actually. My therapist actually suggested that to me to increase my options. unfortunately my credit isn't the greatest at this time   
So my choice is someone in network. There is still the co pay and any deductible that remains, but that I can handle.

Well anyway its going to happen someday just have to stay positive!

I'm sorry for the late reply, but I thought I would answer anyway in case you or anyone else is still looking for information.

I'm fairly certain that Marci Bowers would be more than willing to try and work out MassHealth with you, if you're interested in her. There are also some other surgeons who accept insurance right away -- I think Meltzer is one of them? McGinn may be another. I'm not sure. You could always try calling their offices or sending them an e-mail.

However, they may be out of network for MassHealth and you might have to dig through some paperwork and prior authorizations. As of January 01, 2015, GRS coverage was more formalized in Massachusetts plans, so you could try giving them a call to better understand what it is they do. Also, again, Marci Bowers has an assistant who is willing to work very hard to get insurances to pay for GRS. There are surgeons out there who are willing.

As for your therapist, that's a bit bleak of an attitude to take. I hope she isn't generally that way with you.