Michigan Medicaid

[LadySin 404]

Hello everyone! I'm really excited to begin here, starting my journey. I don't know where this road is going to take me, but I do know want it to lead to a six pack! Someday! My goals here on BP is to read often and make an accountability journal. I may even be so brave as to make a YouTube diary

So, to the question at hand. I have Michigan medicaid and I'm in my open enrollment period. I want to know which of the insurances is it easier to meet their requirements.

Aetna Better Health

Blue Cross Complete

Harbor Health Plan

McLaren Health Plan

Molina Health Plan (Current)

Total Health Plan

UnitedHealthcare Community Plan

I live in the Metro Detroit Area, I'll probably go through Beaumont since my PCP is through there, and I'm also attending the seminar next Wednesday hosted by Beaumont.

Thanks so much everyone!

[LadySin 404]

So after a tiny bit of digging, I find that Aetna may be the best choice. Aetna no longer has a requirement for how long you've had to be morbidly obese (gods I hate even typing that word) (before it was 2 years) Like the other health insurances, there is a required pre-surgery weight loss program. But unlike the others, Aetna has the shortest. If you enter a multi-disciplinary surgical preparatory regimen like the one offered through Beaumont’s bariatric surgery program you only have to do it for 3 months before you're approved (assuming you meet all the other requirements. This is opposed to the 6-month requirements I've seen or even the 12 months that my current insurance offers. Bye, bye, Molina!

Just in case I'm going to wait until the seminar on Wednesday so That I've had a chance to talk with the surgeon. His name is Daniel Bacal. I don't know anything about him, but his picture makes him look like a straight up dad he has great bedside manners.

Edited March 5, 2017 by LadySin

[LadySin 404]

I was wrong, BlueCross Complete is going to be it. Aetna Medicaid is 12 months, not 3. After consideration, I'd feel better about a 6-month wait. There aren't many hoops to jump through either. I've got a 41 BMI, the only thing they want from me is 6 months and a drug/alcohol test.

[jacinthapittman 22]

I'm in the Metro Detroit Area and will be going with Mclaren per my surgeons recommendation. I am havin Dr Pesta at Mclaren Macomb do my surgery. The program there is great, they hold your hand from start to finish and make sure you have everything you need done. All my records from the doctor, psych eval, nutritionist and everything go directly to the program coordinator and she prepares the file to send to insurance.

[LadySin 404]

How far are you into the program?

[jacinthapittman 22]

Going into my 3rd month.

[jacinthapittman 22]

Here are the requirements through Mclaren:
40 + BMI with no comorbidities
35 + with 1 or more
6 months medically supervised with no weight gain
Psych evaluation
Meeting with nutritionist

[jacinthapittman 22]

6 months Documentation of diet and weight loss efforts. Your doctor can document it for you at your appointments but I log my food and exercise into the fitnesspal app just in case

[LadySin 404]

Smart, I should start logging as well. May as well start now, since it's something I'll want to do for at least the first 6 months after my surgery. I'll most likely continue even beyond.

Which surgery did you choose?

Edited March 17, 2017 by LadySin

[jacinthapittman 22]

Yes, I spoke directly to the representative with Mclaren Medicaid who looks over the cases and approves and she asked me if I am tracking my food and exercise.

I am 90% sure I'm going with the sleeve. Don't want to be bothered with the rerouting of my insides and dumping 🤢

[LadySin 404]

I'm still on the fence about my surgery type. On one hand I feel like I'll need the dumping, but on another I have a long term goal of getting into some amateur weight lifting, and I'm just not sure I can when dealing with malabsorption and all that jazz.

I won't get to see my surgeon until I'm 3 months out, but I'll be sure to ask him that.

[ThickGirl5683 318]

Here are the requirements through Mclaren:
40 + BMI with no comorbidities
35 + with 1 or more
6 months medically supervised with no weight gain
Psych evaluation
Meeting with nutritionist

I'm in Texas and these were my requirements with BCBS except I ended up NOT having to do any supervised anything. Got approved in a week and my surgery is on Monday.

[jacinthapittman 22]

I picked sleeve because I prefer the slower weight loss over a longer period of time because I really would like to work out and minimize the lose sagging skin as much as possible. Besides that, you know how slick people can be when people have weight loss surgery.

[LadySin 404]

11 hours ago, ThickGirl5683 said:

I'm in Texas and these were my requirements with BCBS except I ended up NOT having to do any supervised anything. Got approved in a week and my surgery is on Monday.

You go girl! I couldn't imagine doing my surgery so soon. I do wish my insurance required 3 months instead of 6 though. I think 3 months would be a good time for to wrap my head around everything. Commit to lifelong changes, and start building my new wardrobe.

Ah well, I'll be able to accomplish all that in more at 6 months. I just hope my surgeon isn't in demand so I can get in quickly once my time comes.

Keep us updated ThickGirl

[diamondchic94 10]

This is very helpful, I just got Medicaid after losing my marketplace insurance it was way to high!