Medicaid

[bipolarbaby 1]

I live in NC and have Medicaid. Does anyone know how hard it is to get approved? I think my BMI is 40, if I figured right (5'5" and about 240 lbs.). Any info would be appreciated! Thanks!

[mocaba1987 7]

it should be fairly easy if your primary doctor deems in medically neccesary.

[phatkatblue 45]

i have a girlfriend that was approved fairly easy for bypass with medicaid after she met all the insurance requirements...

[mocaba1987 7]

I'm on medicaid.....

[bipolarbaby 1]

Mocaba, did they give you much trouble? What did you have to do to get approved?

[mocaba1987 7]

I'm 426 pounds...is was obvious....my primary care doc, did the necessary paperwork.....

[Rebecca Cain Salpacka 100]

They sent my request in to medicaid oaround march 13 and had approval on mar 27...started all my preop requirements end of january..so as long as you do what they require, it should be easy to get approved.

[BeeJay Knox 0]

I live in Tx and have Amerigroup/Medicaid & they don't require you to get a referral to a bariatrician only for one to deem the surgery necessary. I am finding it amazingly hard still to find a sergeon to accept medicaid. I'm frustrated & disheartened.. Anyone have any advice?

[mocaba1987 7]

Try the public, and state hospitals in your state. Chances are that they have a Bariatrics Unit that takes Medicaid. In NYC, the City Hospitals have fantastic G/BS Units. Some are in the nations Top 50 Hospitals. Also, there are several Bariatrics Groups (which is a specialty based practice, that focuses ONLY on Bariatrics), That have a couple doctors on their roster that will take Medicaid Managed Care.

[mocaba1987 7]

http://www.texasbariatric.com/

Texas Center for Bariatrics

[msjessica2u 0]

I live in Colorado and have Medicaid...I just happened to ask my doctor one day when I was prescribed phentermine to assist with losing weight. He said that in most states if you are 100lbs overweight and have a high bmi and medically proven health issues that they will approve it no questions asked. I am 30 years old and have high blood pressure, lower back problems and an overactive thyroid. I'm only exactly 100lbs over weight but my doctor sent a referral and two months later they called me. There is typically a waiting list for medicaid recipients and it differs in every state. I suggest talking to your General Physician and seeing what your options are. For me it started with the weight loss pills and the fact that they weren't helping whatsoever irregardless of the fact that I was also seeing a dietitian and exercising regularly. My doctor felt that this would be my only hope. I chickened out the first time they called because I wasn't very well educated and really scared but now I know what I'm getting myself into and have my consultation scheduled for May 18th. I wish you the best of luck, please do not hesitate to contact me if you have any other questions or just want to talk!!!

[mocaba1987 7]

It is not difficult to get approved. The problem is finding a Bariatrics Surgeon that will do it for you. Some Bariatrics Surgeons, work under a specialty practice ( in layman's terms- several doctors, one roof, practicing the same type of medicine). Some Bariatrics groups will take Medicaid, under Medicaid Managed Care. Check, the public hospital systems, which definitely have a GE/BS Unit.

[mylynn1377 93]

I have Medicaid in Missouri. My requirements were that I have a BMI over 40 or 35 with co-morbid conditions such as asthma, sleep apnea, diabetes, high blood pressure etc. My primary referred me to bariatrics and I already had a history of obesity with her practice for almost 5 years. Granted I don't need all that but it helps. I just had my consult today and found out the place I am going through is still finalizing contracts with the *** group that I am under for MOHealthNet. That is the only thing that I am waiting on as my bariatric surgery place requires no nutrition or psychiatric evals because my BMI is at 60. As soon as the approval goes in on the insurance I get to schedule my labs and EKG. Once the results are sent to the surgeons and the anesthesiologist I get to schedule my surgery. I'm really hoping it goes fast so that I can get going on this...I'm soooo ready now and patience is not a virtue I was given!

[leslimaree 0]

I also have medicaid and just beginning the process. Did any of you have to do a required diet before being approved? My BMI is 54 and I was told I may have to do a required diet for a year. The lady at the bariatrics center said she was going to see if there was a way to lessen that process.

[mylynn1377 93]

Each state requirements are different I think. As far as I know my state doesn't require one but I had already been on a supervised diet for cholesterol with my physician. It's a good bet if you've had the same primary doc for a while that they have records of any weight loss attempts or discussions that could possibly be subbed in for what they are wanting. I would check on it at least.