Medicaid Requirements

[CandyCrushRNY 2]

Hey everyone! New here, and just started my journey of getting approved for Gastric Bypass. I already called my insurance which is Medicaid - Specifically Maryland Psyhisians Care. Has anyone has the 6 month requirement before being approved for surgery? They did not mention that as a requirement but unsure if that will come up when my PCP tries to send in my forms for approval.

I am a bit nervous about that because when it comes to the excercise part its pretty difficult when you have Fibromyalgia, Plantar Fasciitis and a pinched nerve in your back.

Thanks!

[pear425 32]

I don't have Medicaid but I am familiar with MD healthcare plans. I have BCBS Carefirst Maryland and the 6 month supervised diet is a requirement. Most people I know and have spoken to have needed the diet program. For my plan it is either 6 months in a row or two separate 3 months programs. Weight Watchers, Jenny Craig and any prescribed doctor supervised weight loss programs count. What surgeon and hospital are you gong to?

[CandyCrushRNY 2]

Johns Hopkins Bayview Medical

[pear425 32]

I'm going to St. Agnes with Dr. Averbach. He is doing my revision. Dr Von Rueden did my original RNY in 2005

[CandyCrushRNY 2]

Spoke with 4-5 people from my insurance and still no mention of a monitored diet. Not sure when I will find out. If anyone else has my insurance would love some feedback!

[CandyCrushRNY 2]

Spoke with 4-5 people from my insurance and still no mention of a monitored diet. Not sure when I will find out. If anyone else has my insurance would love some feedback!

[Kat Barrett 0]

My requirements were 6 month visits, Psyc eval, pcp clearance, and some blood and health tests . I am trying to figure out how long medicaid takes to approve my claim???

[ShirleyJ84 41]

Spoke with 4-5 people from my insurance and still no mention of a monitored diet. Not sure when I will find out. If anyone else has my insurance would love some feedback!

candy, I was never told about the 6 months when I spoke directly to the agents but quickly found out it was required when I first saw my surgeon. So now I'm going through the visits and it feels like it's taking forever.

[nervous&happy 12]

Hey everyone! New here' date=' and just started my journey of getting approved for Gastric Bypass. I already called my insurance which is Medicaid - Specifically Maryland Psyhisians Care. Has anyone has the 6 month requirement before being approved for surgery? They did not mention that as a requirement but unsure if that will come up when my PCP tries to send in my forms for approval. I am a bit nervous about that because when it comes to the excercise part its pretty difficult when you have Fibromyalgia, Plantar Fasciitis and a pinched nerve in your back. Thanks! <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/smile.png' class='bbc_emoticon' alt='' />[/quote']

It's probably different based on your insurance but with my medicaid I had to do the following

????Certain blood work done by your PCP

Get 6 different clearance letters

????PCP clearance

????pulmonary & sleep study clearance

????gastroentology clearance (sorry I know I spelled that terribly wrong lol

????nutritionist clearance

????cardiologist clearance

????Phyciatrist clearance

Always make sure to get a copy or even better the original clearance letter & results from each doctor once you have all clearance letters you take it to your surgeon he goes over it to see if anything is missing ... Then he write a final and last clearance letter & sends it to your insurance company to wait for an approval ... You complete a pre-op class and do final blood work last but not least the surgery

Seems like a lot of work but the time goes by soooo fast make sure you do the nutritionist ASAP because they take the longest

I'm currently waiting to be approved *fingers crossed ???? GOOD LUCK keep up with the support groups and hope time flies for you

[nervous&happy 12]

It's probably different based on your insurance but with my medicaid I had to do the following Certain blood work done by your PCP Get 6 different clearance letters PCP clearance pulmonary & sleep study clearance gastroentology clearance (sorry I know I spelled that terribly wrong lol nutritionist clearance cardiologist clearance Phyciatrist clearance Always make sure to get a copy or even better the original clearance letter & results from each doctor once you have all clearance letters you take it to your surgeon he goes over it to see if anything is missing ... Then he write a final and last clearance letter & sends it to your insurance company to wait for an approval ... You complete a pre-op class and do final blood work last but not least the surgery

Seems like a lot of work but the time goes by soooo fast make sure you do the nutritionist ASAP because they take the longest I'm currently waiting to be approved *fingers crossed GOOD LUCK keep up with the support groups and hope time flies for you