Illinois Medicaid Requirements

Hello,

I was wondering if anyone knew the requirements to receive VSG surgery through Illinois Medicaid (Affordable Care Act).  Do they require records of your weight for the last 2-3 years?  I havent been to a regular doctor for the last couple of years so I do not have my weight records but Ive always been "morbidly obese" 5'6 and 260 pounds.  I have been to a neurologist (every 2 months) for the last year or so but he never weighs me.  Ive also been to the ER a few times but never weighed there either.  So if anyone knows if that will be an issue please let me know.  I have have Mitral Regurgitation and was wondering if that will be an issue with surgery.  I have Type 2 Diabetes, PCOS, Anemic, and the ER said I have "fatty liver" but its not that bad.    

It would be best to contact Medicaid in your state directly to find out exactly what they require.  They sometimes make changes to their requirements so even if someone on this forum got VSG and Illinois Medicaid paid for it, they might require different things now than they did then.  In some states (I don't know if Illinois is one or not), there are different kinds of Medicaid and so someone else that has Medicaid in Ohio might have to meet different requirements than I do, even though I also have Medicaid in Ohio.

I have tried calling the 800 number to ask questions but the woman said she couldnt give that information out and that the doctor has to send something in.  I cant really find another number to call so if anyone knows of one I would really appreciate it.  My Medical card says "HFS State of Illinois - Healthcare and Family Services Medical Card" so im not sure if that is a different type or not.  Im new to this, I have only had Medicaid since the beginning of this year!

I'd call the 800 number back.  Of course they can give out information about what Medicaid does and does not cover and require.  If the person answering the phone doesn't know, ask to speak to her supervisor.

I found a different 800 number but they were closed so I will try tomorrow but if anyone knows the answer or that could help me out I would appreciate it!!! 

Here is some info from your insurance http://www.hfs.illinois.gov/html/091112n.html  good luck :)

Thank you so much jaifra78... I really appreciate it!!!

Note though that these are only appropriate for "straight Medicaid" TANF products.  Some other products, such as the new LTC /CHIP / etc products may have different rules, and Medicaid managed care plans will likely have different rules. 

Oh... im a bit confused now.  How would I find out what mine is?  Ive never had medicaid... I just recently been enrolled.  It started January 1st... its part of the Affordable Care Act.  I will try and call them tomorrow but I always seem to be given a different phone number to which they dont know what to tell me.  Ugh

If you have a managed care plan, your card will have the name of that company on it- IL has 3 different managed care plans.  If you have "straight medicaid" it'll have "state of IL" on it .