Question:
DOES KANSAS MEDICAID COVER ANY WLS?
— LaDessa D. (posted on October 28, 2005)
October 28, 2005
CMS guidelines make it possible for Medicaid to cover WLS in any state.
They do not cover every procedure, but they cover the majoirty of the
common, safe procedures. They have to follow the same guidelines as the
community, so BMI and co-morbidities are still improtant. They even cover
revisions if you need one down the line.
— nursenut
October 28, 2005
I apologize, now that I have read your profile, I may be able to provide a
more complete response. First, are you a Qualified Medicare Beneficiary
(QMB)? If so, you have rights under Medi-Care and Medi-Caid. Per
Supplement 3 to Attachment 2.6-A of HCBS-PM-85-3 Title 22 for the State of
Kansas , WLS is not listed among the the excluded procedures. While the
final decision is up to the Division of Medical Programs staff, you can
always appeal the Customer Service person's response. Under Medi-Care
guidelines, WLS is covered.
— nursenut
October 29, 2005
It will depend on the state in which you live. Have you looked in your
state's insurance database? I would check there first. Each state regulates
it's own Medicaid program within the Federal Guidelines. I know that when I
lived in Oklahoma, Medicaid did not cover gastric bypass surgery. You may
remember a story with Carnie Wilson and those two obese twins who lived in
Oklahoma who had their surgery donated to them. Here in Florida, Medicaid
does cover the surgery. Oklahoma may have changed, it's been a couple of
years since I lived there. Good luck!
— Shayna T.
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