Best KY Medicaid plan to choose for sleeve?

bncbabe2015 · August 11, 2015

Can anyone tell me any success stories with your ky Medicaid plans of getting a painless approval for surgery?

Karak2007 · October 16, 2015

I realize you posted this a while ago, but I wanted to comment since I'm trying to get approved on KY Medicaid. I've been advised to go with Passport. I started with Humana CS but they required a 9 month physician supervised weight loss program. Passport doesn't require any physcian supervised weight loss program, but I think it depends on your BMI.

I'm still working through the approval process, but hope to be approved for surgery before Christmas.

bncbabe2015 · October 16, 2015

DO NOT CHOOSE ANTHEM, ever!!!

It's terrible. I've had the worst time with them.

Initially, they told me I had to lose 10% of my starting weight during the 6 month diet. After it was all said and done, they denied me because since I lost 20 lbs over the 6 months, surgery is not "medically necessary" and I can lose weight on my own.

My surgeon was furious and is in the process of appealing.

If the appeal gets declined, I'm switching my plan and will start over starting 1/1/16.

Good luck!

Karak2007 · October 16, 2015

In case you don't get it resolved before the end of open enrollment, just know that you can do disenrollment for cause. I was approved pretty quickly, as in new insurance started within 30 days. I just had to write a letter stating why I wanted to change, and they accepted the need for bariatric surgery an acceptable reason.