I already have Medicare and I went last Friday to my appointment and they said I qualified for Medicaid so can the Dr's office check into the coverage to see if they will cover the surgery because I don't know what is the next step ? Thanks

I'm a bit confused.  You have Medicare.  Do you have Medicaid or you think you qualify for Medicaid?  If you don't already have Medicaid, you must apply for it.  Your doctor's office can't apply for you.  You need to contact the Department of Human Services or whatever they call it in your state (it's the same place you apply for food stamps) and complete an application.  I had to reapply recently when I moved to another county within the same state.  It took about a month for it to get approved.

If you are approved for Medicaid the state will send you paperwork about medicaid and  a ID card when you get your ID card (its a lil different in each state) but I had to choose which insurance company I wanted that medicaid went through(like United health Care, Amerigroup, etc) Then set up a appointment with PCP get a referral for WLS and start contacting or ask your PCP what surgeons will do accept medicaid.

I already have a card from last time when I was pregnant so they said to use that, I already had my Dr to send the referral to the Lakeland Bariatrics  ahead of time because he was leaving the Pratice and he knows me and the problems I have had due to my weight and a new Dr( PCP) won't know me for awhile. I called the the place I wanted to go and they accept both Medicaid and Medicare. Should I call  Lakeland Bariatrics in Holland Michigan, tell them now I have Medicaid and let them check into everything ?

Usually when you go to the "seminar" or your first visit with the surgeon you talk about your insurance usually the coordinator at the center(Lakeland Bariatrics) lets you know what is required so your insurance can be approved.

I also have Medicaid and just received my sleeve on June 3rd. First you need to find a bariatric surgeon that will accept it. Now for my surgery to be covered I had to see my primary care physician once a month for an entire year without skipping a month or I would have had to start over. This to track my diet progress and show a need for the surgery. Once I did this I went to a seminar at my surgeon's office talking about the procedures then was approved shortly after

What medicaid do you have? A whole year???? Yikes I am waiting to go to the seminar on 7/24.... My medicaid won't/ don't know what the requirements are they just keep telling me its covered with prior auth...... Meaning???????? I am hopng I don't have to do a 6month weigh in must less a whole year

Hello,

As your fellow members have suggested you need to find a surgeon that accepts your insurance first and then go from there.  Give The facility you mentioned a call and verify they take your insurance.  Here is a link of surgeons in  your area. Give them a call to find out if they take your insurance.

http://www.obesityhelp.com/find/bariatric-surgeon/?location= Holland%20Michigan

If you need any further assistance please let us know.

 

 

 

With Medicaid, you always start with your PCP (family doctor). Your family doctor will make a referral to a bariatric surgeon, and it is up to your doctor's office to refer you to a surgeon who takes your insurance. If they don't, you take that issue up with your doctor's office.

 

You can find a surgeon yourself, but you won't be able to make the appointment because Medicaid requires a PCP referral - therefore, your doctor's office must make the phone call and provide the medical info for you that they need.

 

After that, your doctor's office/surgeon's office should inform you of the requirements you need to meet. Typically, with Medicaid, they will require at least 6 months of documented weight loss tries (dieting) and 6 months or more of a history of being obese.

Since you have Medicare as your primary (right?) some things may be waived as Medicare is usually quick to approve procedures.

If you have any questions, feel free to send me a message on here.