Wanting to have any help on Approval through MaineCare

I was wondering if anyone could help me on what to expect on the approval through MaineCare. I have went through all my appointments: Nutrition class, dietician, psychologist, physical therapist, etc. And now I have my consulatation date for November 20th to go see Dr. Clough. I am hoping that I haven't went through all of this just for the fun of it. Here is a little history of myself, I am 25 years old, and weight 308. I have high blood pressure, high cholestorol *well, boarderline it is 218* which I take zocor for 40mg x day. I have boarderline diabetic - take metformin 500mg x day. I am also having to take Prevacid for indigestion/heartburn. I have had gestational diabetes with both pregnancies. I am wondering if I just don't have enough wrong with me for MaineCare to pay (we all know how they have been paying for less and less) Could anyone help me out on info that I don't know about MaineCare or any promising words? I am really hoping to go through the surgery, I just hope I dont get disapointment by denial. Thanks

Hi Kristy, Congratulations on completing the WL process! You must be getting really excited. I am actually still jumping through the hoops but my surgeons office has been very reassuring that MaineCare rarely denies a request and if for some reason they did, they would appeal immediately. I do know that MaineCare has recently been changing some of their policies regarding WLS. They seem to approve Gastric Bypass surgeries more quickly than Lap-Band surgeries and they do require comorbidities, which as I read, you do have. It sounds like you shouldn't have any problem. Don't worry until you have to... I'm sure your doctor would appeal any denial anyway.....Try not to let the anxiety of waiting get you down. Your on your way to a brand new chapter in life! Good Luck! I'll keep you in my prayers. Please let us know how things go at your appt. November is just around the corner....

I read on "the skinny" news letter that mainecare does have new guidelines. They now require at least 1 co-morbidity such as high blood pressure, diabetes, etc. They will no longer approve on weight alone. I don't think you'll have any problems getting approved. I also had high blood pressure and have not had to take my medication since surgery, I'm so thankful for this surgery. Best of luck to you. Ann