Problems with medicaid

[jessr0se 1]

I'm a single mom on Medicaid. I live in North Dakota. I heard Medicaid will cover the gastric sleeve if you have a BMI of 40 or higher and at least one other comorbidity. I have a BMI of 41 have high cholesterol and sleep apnea. I am also completing the 4 months of documented diet, including meeting with a dietician once a month for 4 months. However, the bariatric clinical coordinator does not think Medicaid will approve since I'm only 24 and my cholesterol can be lowered with medication. I have been struggling with my weight for close to ten years and even my primary care provider agrees this is a great choice for me. What do I do? Finish the 4 months of the diet and submit it to Medicaid anyways?

[Miss Mac 6,262]

I would think that being 24 would not necessarily be a hinderance since you have sleep apnea, which is a strong co-morbidity. You could stay with the nutrition visits anyway because even if you don't get the response you want from Medicaid, the nutritionist can give you some coping skills and kitchen strategies to help you with weight control. Wishing you good luck and good health.

[Sofficial 162]

I don't think it matter, when they told you the requirements did they say anything about age restrictions? I'm all that clear on how medicaid works in North Dakota but do you have straight medicaid or Managed Care?

[sleevethefatbehind 95]

http://www.ndhcri.org/Healthcare_Professionals/medicaidcasereview/preauthorizationareas/Criteria_for_Bariatric_Surgery.pdf

It does look like they won't cover it if the condition can be controlled with medication, unfortunately.

I'd still finish and submit. What do you have to lose?

[want2besleeved87 60]

I'm a single mom on Medicaid. I live in North Dakota. I heard Medicaid will cover the gastric sleeve if you have a BMI of 40 or higher and at least one other comorbidity. I have a BMI of 41 have high cholesterol and sleep apnea. I am also completing the 4 months of documented diet, including meeting with a dietician once a month for 4 months. However, the bariatric clinical coordinator does not think Medicaid will approve since I'm only 24 and my cholesterol can be lowered with medication. I have been struggling with my weight for close to ten years and even my primary care provider agrees this is a great choice for me. What do I do? Finish the 4 months of the diet and submit it to Medicaid anyways?

I am also a single mother on medicaid, i am also a full time college student and Monday my papers were submitted to UHC Community Plan through MD Medicaid and Thursday I was approved, so even though it looks bleak finish and even if (praying it does) go well Never Give Up.

[jessr0se 1]

That's great! I'm happy for you! I won't give up, im fighting for this. Thanks for the words of encouragement

[want2besleeved87 60]

That's great! I'm happy for you! I won't give up, im fighting for this. Thanks for the words of encouragement

You are more than welcome, and thank you