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Medicaid Appeal??



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I currently have Medicaid and in the process of my six month supervised weight program for bar iatric surgery. They said that in the fifth month we will get a surgery date. And as long as all the insurance information goes through, that will be the for sure "date". But my question is.... does Medicaid deny people a lot the first time around? I’m afraid of the whole deny and appeal process, making the time for my surgery even further away. Don’t get me wrong, ill wait. I just want to be prepared.

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wow what state are u guys in ?? I didnt know medicaide covered this do tell!!!

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I could not find a doctor or hospital that would take Medicaid for my Lap Band surgery in Louisiana so I am self pay. I wonder if I can get the forms and file with them to reimburse me ? The doctors office won't even file it with them because medicaid pays so little and it is such a hassle to deal with them. Where did you find a clinic to treat you?

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I am currently located in PA. I went to a seminar on lap band and talked to the bariatric center and asked who they work with. PA offered three different types of health care plans. And, the Lehigh Valley Hospital in Allentown, said that they dont work with Gateway or Unison, but they do work with AmeriHealth Mercy. They do all the work. As long as you have a BMI of 35 or higher and a health related problem retated to obesity, you will get approved. However, i dont have a health related problem due to obesity but have a BMI over 41, which makes me eligible for the surgery without a related illness. You just have to go through a six month weight loss program supervised with the bariatric center and they will submit all the information for you. It just seemed too good to be true so i was wondering if they often appeal, making the process longer.

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I live in Illinois and have no comorbidities and barely reach a BMI of 40. I am under 40 now that I am on my one week pre-op diet. Medicaid only took a week to approve me once they had my paperwork. Very easy to get approved. It means a healthier you and less bills later on if you are thinner.

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Well let me first start off by saying Congrats!!! I am so happy for you. And thank you for your response, it makes me feel a little more at ease knowing that other people had an easy expierence getting approved. I wish you the best of luck and look forward to seeing you loose them pounds! p.s. i like your quote.:)

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      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
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