Medicaid requirements?

I just signed up on this site today... I went for my first info seminar and completed my intake paperwork. Does anyone have experience with NH Medicaid, and what their requirements are for WLS? And also, is it necessary to meet with your PCP... what are the steps I have to take to get this going? Thanks in advance!

Hi Angela, You definately came to the right place for answers. This web site is really wonderful. I also have medicaid. I didn't need any referrals from my PCP, and that came straight from her office. The program director at my surgeon's office is a whiz with insurance and she said that the requirements for medicaid are the same as the ones for the surgeon. So far I have had my consult with my surgeon. I also am scheduled for a sleep study and I have an appt for a nutritionist. I haven't had to pay anything out of my pocket. Medicaid covers everything as long as a Dr. accepts it. I did some research and picked a surgeon, made sure he accepted it and made the necessary appointments. I haven't even had to deal with medicaid at all. Just make sure you have you insurance card ready for your appointments. If you need anything else, just give a shout. I'll try to help as much as I can. ~Daniela

Thanks for your response!!! I actually do have a few questions... Ok so you know how you have to have a complete physical and blood work and all that, you didnt need to see your PCP for that to get done? How did you go about all that? (I have a non related appt. with my PCP on Tuesday for blood pressure issues and Im wondering if I need to consult with her about the WLS as well?) Because I know at my surgeons office he requires a physical, bloodwork, an abdominal u/s to look at your gall bladder, a psychological consult and a 15 lb. weight loss. Also, does Medicaid require like a certain amount of documented months spent dedicated to weight loss (like Anthem and Cigna were doing)? Ive been told that Medicaid is really easy to approve the WLS... I just feel so overwhelmed! If you dont mind me asking, what surgeon are you going to, and what are his requirements? Right now I am going to the Hitch**** clinic in Manchester.... Thanks for chatting with me and answering my questions....

Angela, No problem at all. If you feel comfortable with your pcp and don't think he or she will have a problem with it, I would go ahead and let him or her know. I am going with Dr. Drinkwater in Nashua. Your surgeon will make all the necessary appointments and all the testing and bloodwork is done in the final stages after you have seen the nutritionist and pshyciatrist. As far as I know you don't need to have a documented diet history. As long as your surgeon feels like you are a good candidate, and you have filled out all the paperwork, you should be on your way. Once you have your consult you should have gotten some appointments made for a nutritionist and maybe a sleep study if you need one. This was how my surgeon did it. Now I just have to wait for those appointments. I felt the same way before my consultation, but now that I know how it will go, it's not so bad. Your surgeons office should be taking care of pretty much everything for you. If not, you may want to call them or find another surgeon that has a more structured program. Let me know if you have any more questions. I'll try to answer them the best I can. Just try to breatheeeeeee. lol ~Daniela

HI Angela, I saw that you are having Dr. Gould and I just wanted to warn you that his program at Dartmouth Hitch**** is NOTORIOUS for losing paperwork like you wouldn't believe. They are so unorganized it is ridiculous. I started out in that program and swicthed, thank God, to Dr. Drinkwater. His program is phenominal and super-structured, nothing like Dartmouth's. Now, this is not a slam on Dr. Gould. I have heard he is a great surgeon. But his team SUCKS. I have a lot of details on my profile about this. It was very frustrating to say the least, and I am not an impatient person. I hope you don't have the experience I had, Angela. If you do, I encourage you to check out Dr. Drinkwater in Nashua. They are a great group of people and Dr. Drinkwater is an exceptional surgeon. He got all his training in Boston and developed the Obesity Center in Nashua. He is fantastic. I have heard that people in Dartmouth Manchester are waiting crazy amounts of time to have their surgeries....that they get all the pre-op stuff done and then wait forever to get a date. I don't know if this is true or not, as I didn't stick around that long, but based on my experiences with them early in the pre-op process, I wouldn't be surprised. Which is really unfortunate because Dr. Gould is a good surgeon. He really needs better staff, though. And by staff, I mean the ones who take our paperwork and schedule appointments. I know his nurse practioner Eric is really good. Anyway, feel free to read my profile for more information. Just wanted to give you a heads up on this. I hope your experience is much better! Hugs, Denise