Indiana Medicaid

Hi All, I was wondering if anyone here has been approved for gastric bypass with Indiana medicaid insurance. I was recently laid off from my job and lost my blue cross and now am covered with medicaid. I saw my doctor today and I have a list of stuff from the surgeon you have to have to get approval, but my doctor said that even though you do all that stuff and jump through all their hoops they seldom approve the surgery. Is this true??? I am going to go ahead and do the stuff but I just don't want to get my hopes up and then be disappointed. I have a few Co-morb's including diagnosis of pre-diabetes, heartburn, anxiety/depression, chronic back pain and swelling in my legs and ankles. Would those things make the surgery medically necessary? I'm dyin' here...lol...anybody have anything good to tell me?

I know of several people that have been approved for ANY type of WLS by Medicaid. Your best bet for a fast approval is A)Call the Customer Service number on the back of your insurance card and let them know that you are seeking WLS, who your PCP is, and who you are looking at as a surgeon for your surgery. Ask them to send not only your PCP but you too a copy of the requirement list. Ask them also for a listing of approved payment sites and surgeons. B) Make sure you follow all their reccomendations for approval. Including all required documentations and etc.. At the time I was seeking approval Medicaid required at least 12 months but not exceeding no more then 18 months of medically documentated weight loss attempts including those with/without a dietician involved. Now (from what I've been told) it's been reduced to 6 months but not exceeding no more then 8 months. Good Luck. And also if you ever have any questions about what EXACTLY (as in word for word) the medicaid review board (even if in an appeal process) wants your documentation to state - DO NOT HESITATE IN CALLING THE CUSTOMER SERVICE NUMBER ON THE BACK OF YOUR CARD AND ASK THE CSR. Ask the CSR as many questions as you want and as often as you want. They have to document every phone call, inquiry, or etc.. on you so when that goes before the case manager with your PCP's documentation for review for approval - your phone calls will count. Jodi

I cannot help you with your question. Just wanted to say hello. I am from Terre Haute also. I am scheduled with Dr. Gomez on April 23rd. That date cannot get here soon enough. Maybe we can get together sometime and talk. Do you know there is a support group in Terre Haute. Our next meeting is March 26. If you are interested, I can give you more information. Just email me at [email protected] Good Luck Deborah

Hi, I'm from Terre Haute too! Linda Vicory

Hi Stephanie I am in Terre Haute also and just had my surgery on 2-26-07. I am on medicare disability as well as medicaid disability. I was approved in just a few weeks. there were a few conditions 1. had to go to ST vincent with dr diaz( must be a surgeon at a center of excellence) and Dr Diaz is the only one at st v willing to work with medicare/medcaid. had to have at least 6 months of dr approved weightloss attempts. get your records from your pcp and take them with you the date of the consultation it speeds things up as they can tell you what you will need. Also the pshyc eval at st v you have to pay 110.00 the day of the psych eval. DR gonzales in Terre haute will do it and bill medicaid no out of pocket expense. if you call st vincents and tell them you are on medicaid and you want to schedule a consultation heather and amy are real nice nd will help with everything you need good luck