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.
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.
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
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.
Oh, I did have to send in my weight from the last 5 yrs. I just got that info from my OB/GYN.