medicaid
Hello 
My insurance only covered 60% of the surgery and I was responsible for the rest. So technically, I can't answer from experience but I can try to guide you in the right direction.
Must be a Center of Excellence.
Have you picked your surgeon? If not, take a look at the following link. Posters have identified which surgeons accept Medicaid. Call them up and ask for requirements. Be aware that office may have an additional program that must be completed and may come at an extra cost.
Which surgery are you thinking about?
http://www.obesityhelp.com/forums/IL/3461375/MEDICAID-AND-MEDICARE-SURGEONS-LIST/
My insurance only covered 60% of the surgery and I was responsible for the rest. So technically, I can't answer from experience but I can try to guide you in the right direction.
Must be a Center of Excellence.
Have you picked your surgeon? If not, take a look at the following link. Posters have identified which surgeons accept Medicaid. Call them up and ask for requirements. Be aware that office may have an additional program that must be completed and may come at an extra cost.
Which surgery are you thinking about?
http://www.obesityhelp.com/forums/IL/3461375/MEDICAID-AND-MEDICARE-SURGEONS-LIST/
**Weight loss since June 08**
I used Illinois medicaid for RNY. My BMI was over 50, but you can get surgery with a BMI over 40 or over 35 with comorbidities. I didn't have any comorbidities other than displaced knee caps.
My surgeon was Dr. Nagle at Northwestern in Chicago. While IL medicaid does not require a waiting period or diet, my surgeon's program did. So I went to the seminar in May, then I had appointments with surgeon etc, 4 pre-op nutrition classes (one a month), then surgery in November.
So medicaid did not require me to wait, but the program was paced where there is some waiting time. This will, of course, vary depending on your surgeon. Personally, I think it was a good thing for me to have plenty of time to actually think about my decision and new way of eating.
IL medicaid is also not requiring pre-approval for surgery right now. If you meet the requirements (which it seems you do), then medicaid gets billed after surgery. Also, I wanted to add that I did have to pay out of pocket for psychological evaluation and nutritional visits.
As far as things I had to do before surgery, I first found a primary care physician that was accepting of the surgery b/c they will have to write a letter for your surgeon to submit to insurance. I also had a psychological evaluation (surgeon had a list of psychologists to choose from). That's all I can think of. I hope this helps.
My surgeon was Dr. Nagle at Northwestern in Chicago. While IL medicaid does not require a waiting period or diet, my surgeon's program did. So I went to the seminar in May, then I had appointments with surgeon etc, 4 pre-op nutrition classes (one a month), then surgery in November.
So medicaid did not require me to wait, but the program was paced where there is some waiting time. This will, of course, vary depending on your surgeon. Personally, I think it was a good thing for me to have plenty of time to actually think about my decision and new way of eating.
IL medicaid is also not requiring pre-approval for surgery right now. If you meet the requirements (which it seems you do), then medicaid gets billed after surgery. Also, I wanted to add that I did have to pay out of pocket for psychological evaluation and nutritional visits.
As far as things I had to do before surgery, I first found a primary care physician that was accepting of the surgery b/c they will have to write a letter for your surgeon to submit to insurance. I also had a psychological evaluation (surgeon had a list of psychologists to choose from). That's all I can think of. I hope this helps.
I am still pre-op, but Medicaid is coving my surgery. Their requirements are:
BMI >40 or BMI>35 with co-morbitities
Clearance from Psychiatrist, PCP, Surgeon, Dietitian
So pretty simple. You more than qualify. My BMI is 41 with no co-morbitities. So it just depends on the program you are going through. Mine is Methodist Bariatric in Peoria. I have gone to the seminar, had my initial consultation, had all of the pre-op testing, and Monday I see the dietitian, psych, and exercise specialist. So if all three of them clear me, they will schedule a date. Good Luck!
BMI >40 or BMI>35 with co-morbitities
Clearance from Psychiatrist, PCP, Surgeon, Dietitian
So pretty simple. You more than qualify. My BMI is 41 with no co-morbitities. So it just depends on the program you are going through. Mine is Methodist Bariatric in Peoria. I have gone to the seminar, had my initial consultation, had all of the pre-op testing, and Monday I see the dietitian, psych, and exercise specialist. So if all three of them clear me, they will schedule a date. Good Luck!
5'0" HW-214 SW-186 GW-115 CW-96-99
Yes Medicaid does cover WLS, they only cover two and they are Gastric bypass, and sleeve gastrectomy. Some places like Northwestern hospital wants you to pay out of pocket 500 HUNDRED DOLLARS. Iam one that HAD THE MONEY BUT DIDN'T HAVE THE MONEY went to UIC 1801 TAYLOR ST in Chicago, IL, and they cover ever thing. I had to do six months diet this only gets you prepared for the best to come it go by so fast u forget when you started your journey. GOOD LUCK! IF YOU NEED MORE JUST LEAVE ME A MESSAGE. JACKIE. By the way i have family that live in Zion.
IT'S ANOTHER DAYS JOURNEY, I'M GLAD ABOUT IT........... PROVERBS 3: 6 In All Thy Ways Acknowledge Him, And He Shall Direct Thy Paths.
I am a new member. I am in the process of trying to get Gastric Bypass surgery and I have Medicaid. I have Lupus, so I do not fit the criteria for the Lap band. I am just wondering, does Medicaid cover Gastric Bypass? I was told by the doctor's office that Medicaid does not cover anymore, only for Lap band. I hope this is not the case, since I cant get the Lap Band. Is it possible that the Bypass would be covered due to me not being able to have the Lap Band? I am really worried. I did all of my required tests and am now waiting for my appointment on April 21 for the submission of the paperwork to Medicaid. Anyone heard of Medicaid not covering the Gastric Bypass?
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