BARIATRIC SURGERY WITH MEDICAID

DreamerGiftGirl
on 4/28/12 7:50 am
DOES ANYONE KNOW IF MEDICAID COVERS BARIATRIC SURGERY AND WHAT THE PROCESS MAY LOOK LIKE?  I STARTED THIS PROCESS AND I HAD OXFORD.. THEY JUST REQUIRED 6 MONTHS OF VISITS WITH A NUTRITIONALIST OR DISCUSSIONS WITH PCP ABOUT WEIGHT LOSS.
WHAT DOES MEDICAID ASK FOR?  6 MONTHS OF VISITS A YEAR??
TamaraL
on 4/28/12 8:33 am

each state is different.  You would need to call the state medicaid program.  the 1800 number.  the local office will not know.

A lot of states have stopped covering weight loss surgery.  you could also try to google and see if it will cover.

 



 

devaoner
on 4/28/12 8:54 am
  It's different in each state, but I had cadiologist pulmonary and physc but I also know that not every dr take Medicaid so check with ur insurance find what's required, I also had to have some conditions before they would consider me for surgery good luck
chelsea41808
on 4/28/12 11:28 am - OH
RNY on 05/14/12 with
 in ohio .. you have to have a doctor that the hospital is in the excellent program then..


-referral letter from family doc
-6 months with dietitan
-upper gi
-ultrasound of everything it seemed like
-sleep study
-psych val
-cardiac clearance
-attend a least one surport group meeting 
-lose 5-10% of weight
-lab work
-non smoker
  
its alot but so worth it .. i finally got my date . ive been working at his since august
 


rhonda G.
on 4/28/12 9:59 pm - East Liverpool, OH
 i am in ohio. and have united health cared community plan.

i had to have all of that but no ultrasound, and i didnt need a sleep study , but got it done just in case, i didnt loose 5-10% but i did diet the 6 months before surgery, and follow with a dietician. and i got approved first try... now ia m 4 weeks out today! and doing wonderful!
Jackie McGee
on 4/28/12 12:01 pm - PA
Call the number on your card or talk to your PCP/doctor's office. Medicaid will cover everything in most states.

 Proud mama of Mischa and Gabriel, both born post-op.

comeundone
on 4/28/12 2:41 pm - OH
 Call a bariatric surgeon in your area they can tell you if they take it,The doctor said they did my insurance told me they don't (The woman on the phone said that's the official statement  she must say but she knew they did cover sometimes so she told me to try ) I did not try preauthorize just had them submit the paperwork at the end and was approved.What state are you in and insurance also there is an insurance this might help 

http://www.obesityhelp.com/morbidobesity/members/insurers.ph p

Since I live in Ohio here are the two medicades I know of requirements
http://www.wellcare.com/WCAssets/corporate/assets/HS006_Bariatric_Surgery.pdf

http://www.caresource.com/en/media/global/Obesity_Surgery_2012.pdf




HW 289  SW 242
      
cegirl6
on 4/28/12 3:23 pm - Westminster, CA
RNY on 03/12/12 with
 I'm in California and except for the psych clearance, I was covered 100%. Only took 6 days for approval but my surgeons office had a 10 month medicaid, here its medi cal, waiting list.  No 6 month nutrition visit just two yrs of medical records, a seminar where you meet a surgeon, one support group meeting, one nutritionist meeting, and a psych clearance. Then its submitted for approval.  I have a medi cal HMO and the medical director actually does the approval.
                                
songbird177
on 4/28/12 3:46 pm - Carmichael, CA
DS on 12/03/12
Some states cover it, some don't. It also depends if it is straight medicaid or not. I am in california, it is called medi-cal here for some reason and I also have Anthem. I have been trying to get it for the past 4 years. I have been told if I just had straight medi-cal it would have been easier to get approval. I had to call up anthem to see if it was covered. It is. But they keep delaying and denying me, even though I am a 50 BMI now (was 49 at the time of appeal), with 2 pages long of comorbidities. I then called around to see what doctors accepted my insurance. Good luck. I hope it is covered for you.
Ashley O.
on 4/29/12 5:05 am
its different for different states. i'm 16 and had the vsg back in august... they required 3 months of visits pre-op and written letter of medical necessity and what not.. but it was a very easy smooth process for me. I had united healthcare at the time, aswell as caresourse/medicaid.. UH wuoldn't cover **** but caresource did, which i'm extremely grateful for.

again its different for each state though. i'd call the number on your insurance card and ask to speak to someone who can tell you what the requirements are.

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