NC medicaid approval

on 7/15/13 10:09 am - kinston, NC

I have NC medicaid and I have done research. I know they will pay for gastric bypass by one criteria is that I must have 2 years of documented attempts to lose weight. Does anyone else here have medicaid and had surgery. Would love to know how I would come up with 2 years of documentation when I stay on a diet about 3 weeks at a time. If I could stay on a diet for 2 years I wouldn't be obese.



on 7/15/13 10:15 am - OH

You'd need copies of your medical records from doctors showing they talked to you about your weight and you tried to  lose weight.  I don't think it means you had to stick to a diet for two years.  It would just need to show that over a period of two years, you made multiple attempts to lose weight (that didn't succeed).  Sometimes they will also take records from programs like Weigh****chers.

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on 7/16/13 3:19 pm - lexington, NC
I am also in NC. My Dr is searching for a surgeon for me. Wake forest baptist health has a year waiting list. I want this soon. I have high blood pressure, arthritis and no cartilage in my knees. I was told by orthopedic surgeon I was too young and weighed too much. He recommended gastric bypass so has my primary Dr. Just waiting now to try to find a surgeon I'm willing to travel in NC to find a surgeon.
on 7/17/13 3:20 am - Williamston, NC
RNY on 01/04/13

I have NC Medicaid and had RNY on Jan 4, 20013. I don't remember needing the 2 yr documentation of weight loss but I had to jump through a ton of hoops, was denied and appealed. The day before the phone conference with the appeals judge, I was approved (they finally got the one letter I needed from my nutritionist). I did have to do a 6 month supervised plan with my PCP, just went monthly for a weigh in and told her what I had changed that month to help with weight loss(more exercise, cutting fast food, more water). I didn't have any co-morbidities so I was afraid they wouldn't be able to work with me but my BMI was so high that it wasn't a problem.


Good Luck!!

Oh, I did have to send in my weight from the last 5 yrs. I just got that info from my OB/GYN.

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