Need some info on GB....and Medicaid

I am wondering if there are any members here that have had their RNY covered by Medicaid.  I had my RNY here in NY, but my daughter is wanting to have RNY done in Colorado.  What is the "typical" procedure and clearances needed??? I am assuming that there has to be some co-morbidities with weight.
I had to have pulmonary, cardiac, primary physician and psych evals and clearances, and wondering if this is the norm in Colorado with Medicaid. 
I'd appreciate if anyone can help me out with some info on how long it takes, tests and clearances needed, and physician recommendations.  Thanks so much, Lena

challenge presents is finding a doctor that will perform surgery with medicaid. I'd start by calling the various doctors in the STATE to find out requirements for medicaid approval they would know and probably answer better than calling medicaid directly.

I live in Longmont, CO and am on medicaid. The requirements(to the best of my knowledge) are that you have a BMI of 40 or higher. If your BMI is below that, you must have 2 comorbidities. These generally consist of PCOS, diabetes, high blood- pressure, GERD, etc. Medicaid seems to be more concerned with what your physician recommends, as far as whether they believe WLS would be beneficial for you. I know there is a surgeon in Fort Collins (can't remember the name but should be easy to find because it is a bariatric surgery center. There can't be that many up there). And the one I know of in Denver is Dr. Georgescu which is who I am going through. If you have any questions for me I will be glad to help however I can because I had all the same questions and it was hard to find info regarding medicaid in CO. Hope this helps a little:)

Oh BTW, Dr Georgescu's next WLS surgery seminar is Oct. 14th (Sept. was full) I will be glad to send you the info if you would like. Also, I think medicaid only covers RNY and lapband. I am not positive on that though, Something to ask the surgeons office for sure.

Please do send me the information....Thank you so much! Lena

I am on Colorado Medicaid and am just beginning the process (awaiting surgery date.) 

Here's what I know.  Yes- Colorado Medicaid requires that you have at least a BMI of 40.  And, yes you have to have some co-morbidities.  I'm going the University of Colorado Hospital and my doc is Dr. Schoen.  I was told when I put my name on the waiting list (only a month ago) that there was a 6month wait.  Well, they called me a week ago last friday and my name came up.  I went to my appointment and met the criteria for Gastric Bypass.  I chose that over Lap-Band because they're finding that the Lap-Band isn't having good long term success.  Medicaid won't pay for the Gastric Sleeve bc they don't have statistics and long term success. So, that left me w/the Gastric Bypass.  I have to complete a Nutrition Class (mine is September 19th) and that has to be paid for in CASH out of pocket- Medicaid won't cover it.  Thank God my Dad offered up his wallet- he wants to see me happy & healthy.  I also have to have a psych evaluation.  There is a Psychologist in Colorado Springs (where I live) that takes Medicaid for WLS.  The two docs that Univ of CO Hospital recommended in Denver take respectively $180 and $200 out of pocket and won't accept Medicaid.  Why if I live in Colorado Springs did I go to Aurora? LOL- No docs down here who do WLS accept Medicaid.  Anyways, I was told by the scheduler, that as soon as the class and psych eval were done, she could submit a prior auth to Medicaid and that they take exactly 34 days to approve (and that is actual days, not business days.)

I hope this answers your questions.

Good Luck to Your Family & God Bless,
Mel

Hi there,

I have Colorado Medicaid, traditional.  I called around to the different bariatric surgeons, all of which are on the Medicaid list as contracted doctors.  Dr. Shoen (sp) with University Hospital in Aurora is taking patients, but has a 3 month waiting list and requires a referral from a primary care physician.  None of the other docs are taking new patients.  EXCEPT Dr. Matthew Metz in Parker.  He does not require a referral from a PCP (neither does traditional medicaid).  I had my consultation on 10/6, my prior authorization was approved dated 10/14/10 and I'm having my RNY surgery covered 100% on 12/14/2010 at Parker-Adventist Hospital.  I could have had it this month or early November, but I am a full time student/SAHM and needed to wait til the end of my college semester.