Staywell (medicaid)

Hi, I am new to this site. I am currently pursuing bariatric surgery. I am using Shands of UF bariatric center in Gainesville. I have met with my surgeon, and have had my swallow study so far. I still have to have a sleep test, psychiatric exam, meeting with nutrition, blood work, and EKG. I have an appointment for all this in a couple weeks.

I was curious if anyone has used Staywell insurance. My first question is: will they cover the gastric sleeve? I called and asked but the lady I spoke with at staywell said she couldn't find and thing that said they didn't and to just submit my stuff and see (that seemed odd to me!). My second question is: Does staywell require the 6 month supervised diet? Again, the lady I spoke with said they just required approval from my PCP. That seems odd too! Third: what counts as supervised diet? I have years of dieting with a doctor, but idk if I have 6 consecutive months. 

Thanks!

Staywell requires 6 months nut visits. Your visits can't be too far apart but they don't require it to be consecutive. Supervised diet is going to your Pcp discussing weight loss attempts & recording each weight per visit . Staywell will cover it if you meet the criteria. 

Thanks for the info! 

So it has to be 6 months with an actual nutritionist or does the visits with my PCP count? 

So you never went and saw a nutritionist, right? Just did the PCP visits and you got approved? 

6 months with your PCP... I spoke with 4 different people at staywell and they all say they don't have a 3 or 6 month rule all you need is a letter of necessity from your PCP....but my surgeons office says it's 6 month...UF Health of Jacksonville.  So I'm confused but I'm at 5 months PCP visits and all my other requirements are done so I'll just see what happens. 

Thank you! :)

It's definitely 6 months.  I know someone that just had their surgery through Staywell & they were required to do 6 months

Is that surgery in south florida???

Hello,

 I have stay well/wellcare insurance. I had my rny surgery on 10/22. I was approved with 6 months of pcp visits,a psych evaluation, a letter of medical necessity from pcp and an endoscopy and a gallbladder ultrasound. My surgeon informed me of what was needed and then they submitted and I was approved. If you ask your surgeons office they will tell you everything you need. Do that and you should have no problem being approved and approved quickly. My paperwork was submitted on a Thur and was approved by Monday. Good Luck and God Bless on your journey!

Alma

Did you have to see a nutritionist or just the weight loss program through your PCP?