In need of help

[Princess 17 0]

Hello everyone. I’m thinking about weight loss surgery. Can anyone tell me how to go about getting my Arkansas Medicaid to pay for it?

[Matt Z 4,139]

21 minutes ago, Princess 17 said:

Hello everyone. I’m thinking about weight loss surgery. Can anyone tell me how to go about getting my Arkansas Medicaid to pay for it?

Well, typically you first need to see your primary care doctor and have them refer you to a bariatric surgeon. You should also reach out to your medical insurance to see what is, and isn't covered and what restrictions or qualifying factors they are looking for to approve the procedure.

Most insurances require a certain BMI or higher, or a lower BMI plus co-morbidities like sleep apnea or high blood pressure or diabetes to approve the procedure at a lower BMI.

A quick search online and I found this:
https://www.sos.arkansas.gov/uploads/rulesRegs/Arkansas Register/2009/oct_2009/016.06.09-036.pdf

it's a bit older, but it'll at least get you into the "Ball park" range for what is and isn't covered and when.

[Princess 17 0]

Thank you so much! I will look into it. I lost my pcp so I’m trying to find another good doctor but its been hard

[Matt Z 4,139]

Just now, Princess 17 said:

Thank you so much! I will look into it. I lost my pcp so I’m trying to find another good doctor but its been hard

See if you can talk to a bariatric surgeon and find out which PCP's they work with often, this way you get the PCP that you know is ok with WLS and one that's already working with a particular surgeon means they already have lots of practice with getting these things processed.