MEDICAID-STAYWELL

Does anyone have any experience with Staywell Insurance?? Apparently they are an HMO of MEDICAID, they won't tell the patient anything about what their policy is for WLS. They told her that so long as it is medically necessary..so she asked for the definition of "medically necessary"..they said the only ones that know that are the authorization dept..and they dont speak to patients..only doctors.. AMAZING!!!! Any info you guys can provide would be a great help!!! Thanks, Enzo

I am not exactly sure what "medically necessary" means to them, but I was just approved and have absolutely nothing wrong with me. (except for the weight, obviously) In my approval letter it said they found it was "medically necessary". Tell your friend not to let the medical terms scare or discourage her. If the surgeon and her doctor say she is a WLS candidate, most of the time it will be deemed "medically necessary".