medicaid insurance

hello, I found this site several years ago, and at that time there were alot of people in NE covered by medicaid and having surgery. I also have medicaid coverage and have wanted surgery for a long time, so I picked a doctor, and got the ball rolling. However, it seems that NE medicaid is getting stingy of late, or something, as I have a friend also covered, who has diabetes, asthma, is a bmI quite high, ( almost 50 I think) and is only in her mid thirtys. She told me this summer she had been denied the surgery. I have been denied for the second time myself. Initially they denied me for not having a psych eval submitted, and no proof of previous medically supervised weight loss programs for atleast one year. I submitted both items in march of this year (04). Yesterday I recieved a letter saying I am denied again because there is no proof of medically supervised weight LOSS ( not programs) , and that they in their opinion I would be unlikely to comply with aftercare programs necessary for success following this type of surgery ( no reasons why they come to this conclusion, and despite psych evaluation which states that I am very likely to comply with aftercare programs). It almost sounds like they are just pulling reasons out of their backsides. Has anyone else recently had any experience with medicaid (united health care, primary care plus, or care advantage) recently, and how you were approved or denied? I would appareciate any help. thank you, Janet.

Did your doctor put in for Lap-band ??? Becuz I don't think Medicaid approves Lap-band. May be if you had him put in for rny by-pass surgery they might ?? Good luck!!

I had Medacaid Insurance and was approved the first time through, all in all about 6 weeks, (read my profile) and the fact that your Dr. didn't tell you that you would need a phych eval with Medacaid bothers me. Of course I had a Lap RNY and you didn't mention what type of surgery you were having. Who is your Dr.? My Dr., Dr. Goering had everything in order so everthing went smooth.

Hi, thank you both for responding. Yes, I did put in for lap-band. No one told me that medicaid would not approve a lap-band surgery. I am going through Dr. Mcbride, who is in with Dr. Thompson( who does the lap-rny's) at UNMC in Omaha. I'm really kind of leary of the rny as it seems so drastic and irreversable, and with the kind of luck I usually experience I'm afraid of regretting the decision, or having something go wrong, and not being able to reverse it. thank you. Janet.