New York State Fidelis/ Medicaid

[IWant ToDelete MyProfile 37]

I’m just posting this for posterity because I couldn’t find any relevant or recent information on my insurance NYS Fidelis/ Medicaid. It would’ve been nice to have a first hand point of reference.
To start, the entire process has been a breeze.

From the beginning:

- They do not require a referral from your primary care but you will need a letter of support towards the end of your program. Meaning, you WILL need a primary care doctor that can get you in to do a pre-op assessment etc, towards the end of your program (that may just be my doctors requirements though.)

- They require 3 bariatric doctor visits, 2 visits with a dietician, 1 visit with a bariatric psychologist. Making it a 3 month process. Availability with your bariatric center will dictate the timeframe depending on if they are backed up or not. But Fidelis ONLY requires those visits spread across 3 months.

- Finally once you complete those requirements your doc will submit to Fidelis for approval. I know timeframes may vary but my doctor submitted my paperwork on May 31st. Fidelis received it the same day and replied by 1am on June 1st (less then 24hrs) stating they needed the clinical chart notes and proving I met all my program requirements etc. My doctor submitted the necessary information and I received my approval this morning June 8th, again at 1am.

Of course this timeline also depends on how on top of things your bariatric office is. Mine is very proactive but they were a little backed up because of Covid so the process took 5 months instead of 3.

But as far as Fidelis goes they are very responsive and quick to reply. I have had a great experience thus far and am looking forward to my surgery July 6th!

Any questions feel free to ask now or in the future!

[torezz1111 3]

I have Fidelis in NY - I have had two visits with surgeon, I have a psych I use monthly so that was done, I completed nutrition, I have evidence of 20 years of weight struggles, my echo is done, pulmonary test are done- I have restrictive breathing due to being overweight.. I just have my endoscopy Friday. Do they need the endoscopy to submit?