Medicaid peeps listen up!

I just wanted all the Medicaid people out there know that I have been approved for the gastric sleeve. Do not let anyone or anything hold you back. It is possible. Even my own PCP, doubted it. I have been hard at it for months going through a bariatric program and I followed everything that was asked of me and I had no comorbids just a BMI over 40. I was told to expect a denial. In less than 2 full business days I had an answer. It took them almost no time at all to approve me. 

Even if people along the way doubt you or the process, push that much harder. It will be totally worth it and anyone with questions feel free to ask!! From what I gather, all of this medicaid managed care plans are something new to alot of people. I will be more than happy to help. I am from Ohio.. 

I should find out tomorrow if my surgery will be Dec or Jan.

Congrats to you!! Way to go and stay the course of pursuing your surgery.

Every state and county runs their different though. So just because you go approved means everyone else will. Managed care is run by the actual insurance company. So if they approve WLS as long as you follow all the quideline I am not sure why you wouldn't have been approved. Your surgeon will actually get very little since medicaid is not known for paying much. I know my surgeon takes medicaid and even though I did not use it I know people that did. I wish you luck.

Yes, Medicaid is a state run program.  The rules will vary by state.

I completely understand each state is different which is why I stated that I am from Ohio. There were alot of hoops for me to jump through and the answers I needed werent always readily available.  The ohio forum is rarely visited so I feel like this was a better place to post. I just want to get information out to those who need it.

Did your surgeon's office have an insurance guru? Mine did and she told me exactly what to do for my insurance.

I too used my state's Medicaid (called CentennialCare) and was approved with a bmi of 45 and no co-morbidities. I live in New Mexico. I had a very supportive PCP and was told exactly what I needed to do by the insurance coordinator at my surgeon's office. They sent in what was needed and was approved within a week of submitting only one time. I've been told that some MCO's here approve the surgery and some strictly prohibit it. I guess I was just lucky that I was with one that approves.

What do you mean by Medicaid? Do you mean Medicare? Medicaid is not health insurance.

State funded health insurance is called Medicaid in many states.

Yes.  It is government insurance managed by each state.  It is insurance for people who can't afford insurance.  In NYC, we refer to it as the gold card.  It pays for everything private insurance does not. Like No co-pays or deductibles nor fees whatsoever (goodbye $500- hospital fee, goodbye $250- emergency fee, goodbye $200 ambulance fee farewell $2000 deductable for out of network providers, etc- agh that felt good!!!).  It covers dental, optical, and in NYC free cell phones  (2 per household) & service.  Just added is prescriptions and vouchers for the farmers market - too help poor people eat more fruits and vegetables and maybe ward off illness lowering medicaid costs.

So yes its health insurance and its a mighty fine one at least in NYC.  I've always heard we had some of the best - maybe because we pay outrageous taxes.

Best

L.