medicaid requirements

[newmommy395 0]

Hi all, i am trying to find out what the medicaid requirements are for lap-band. I have already found the surgeon and all of his info. Thank you in advance for any help.

Shelly :thumbup:

[sistasassy 6]

Medicaid requires a BMI of 40+ or a BMI of 35+ with two or more co-mobidities (high blood pressure, arthritis, lack of bladder control, diabetes, etc.).

If you meet the above criteria then you have to have a psych evaluation (which Medicaid does not pay for and runs anywhere from $200-$700) and a nutritional evaluation (which Medicaid does pay for).

You doc will then submit your paper work for approval.

I live in Illinois and mine was approved in about a week and a half.

[newmommy395 0]

wow that was quick!! Are you going through Dr. Lutfi or someone else? Do i need anything from a primary care dr. or 6 month supervised diet? I definitely have the bmi for it.

Thank you

Shelly:smile:

me and newmommy395 are the same people...different computers

Edited September 3, 2008 by new_mommy05
same person

[sistasassy 6]

I am using Dr. Albert Gilman in Illinois.

There is no pre-op diet requirements for medicaid. Once you get done will all your pre-op testing (which the doc may have a list of his own tests), you should be good to go.

It is almost easier with medicaid than any other insurance. I think it is because the surgery will reduce their costs down the road.

Good news for us! I have a family of seven and we have no insurance so medicaid has been a lifesaver for us.

I am supposed to be banded by the end of the month. We are just working on the date right now. I am very excited and starting my pre-op diet in the morning to get my liver in good shape. I can't wait!

[newmommy395 0]

Thank you so much for your responses. Sorry if i was getting a little repetative but its just so hard to believe that there arent too many requirements. Hopefully I can get a call back so I can go to info session and get the ball rolling.

Shelly

[sistasassy 6]

You should be fine. The doc will give you a list of the tests he wants you to have too but all of those are covered by medicaid.

I had to have a sleep study, EKG, ultrasound of my gallbladder, Upper GI, blood work, and a few other things. They are easy to have and sometimes you can get more than one test done in a day. The sleep study was a pain. Had to spend the night at the sleep lab for that but the room there was nice and it was painless.

In the end, it is really very little to do in order to be healthy again. I am sooooo looking forward to that.

Don't be afraid to ask questions and to read read read on here. This is where I have learned alot. Digging through the old posts helps too because you can see that people have been doing this for a while now.

Also, be sure to read the good, the bad, and the ugly about all this. That way you are really ready. I have forced myself to read some of the stuff that has gone wrong just so I know it can (but rarely does) happen.