MEDICAID AND MEDICARE SURGEONS LIST!

 Hi =)  I am currently going through the process of getting approval from Molina (Medicaid).  The first place to start is with your surgeon. They should have an insurance coordinator who will tell you everything you need to do based on what insurance you have, step by step--- and believe me, it's a lot! I can tell you it starts out with a 6mth documented diet supervised by a physician. Usually the standard for medicaid is poorly controlled co-morbidities. Other things that may qualify you is having to have knee or hip surgery but too heavy to have it done, diabetes, etc. You never know unless you try. I have been denied by Caresource before. I have gotten "sicker" and have changed insurances since then so...had to try again. If it helps, I've heard that Molina is more likely to approve you than the other Medicaid insurances. Good Luck!

I do not believe that State of Ohio (Medicaid) covers Bariatric surgery.  I deal with that issue for my job.  There is a difference between a hospital and doctor being a Medicaid provider and the surgery being covered.  Some hospitals/doctors may choose to provide the service any way but Medicaid won't reimburse them for their services

David L. Schumacher, MD. 
2115 Leiter Rd.
Suite 100
Miamisburg, OH   45342
Phone: 937.384.6922
[email protected]

GREAT doc in Dayton area. My friend and I drove from Columbus to have surgery with him. Very kind and funny man with a great staff. He accepts Medicare/Medicaid. No prior authorization required by Medicare.

I know for ages 14-18, i think it may go up to 25, Cincinnati Children's Research Hospital has a Teen Weight Loss Surgery program, and They take medicaid(caresource). They were really happy that was one of the insurances i have because they're quick to respond and already know the program well. It's the program I'm in.

3333 Burnet Ave. Cincinnati, OH. I'm not sure the phone number, I have it written down somewhere. But you can look on the website. Or just google 'Cincinnati Childrens Weight Loss Surgery' and the page should come up. 

I am dually eligible for Medicare and Medicaid and this is my surgeon:

Robert Woodruff, MD
St Joseph & St Elizabeth Surgical Weight Loss Center
452 Broadway Street
Youngstown, Ohio 44501
Phone: 330-480-2866
Email: [email protected] 

www.ehealthconnection.com/regions/youngstown/content/srv_bar iatric.asp

My doctor is Alan Saber at UH Case Medical Center 11100 Euclid Ave
Cleveland, OH 44106 Phone: (216) 844-5274
I have Wellcare of Ohio and was approved for the Gastric Sleeve The approval took 1 week to receive. Wellcare stated they had 14 days to decide and told me a half hour before the doctor office called to say I was approved they still had not made a Decision.

.

 Dr. Bruce & Dr. Clarey out of Dayton/Miamisburg would work out of Grandview Hospital in Dayton, OH took my Medicare/Medicaid.
As for the problem with Medicaid paying bills right now is because they changed to a new billing system in October.  It's a temporary issue,  with a software issue, how I know this, is I am one of the client's whose bills haven't been getting paid.  I have been reassured to have the bills resubmitted.
My gastric bypass was covered due to my doctor's saying that it was medically necessary and life threatening if I didn't have it.  The best thing to do is call their office and ask questions.

My RNY was 2003 and I have lost 195lbs. gained some back due to steriods and have lost another 80 lbs again.  I am down to 183lbs now.  I am very happy with my progress :)


Anyone need any assistance please let me know,
Cally

How did you get your insurance to approve the surgery? 

I HAVE CARESOURCE.I WAS DENIED THE FIRST TIME.I THOUGHT I HAD ALL MY PAPER WORK IN THAT WAS REQUESTED AND THEY REQUESTED ME TO GETA PULMONARY CLEARANCE.I JUST GOT THAT DONE AND AN AP PEAL WAS SUBMITED LAST WEEK.IT HAS BEEN 10 MONTHS NOW IVE BEEN WORKING TO GET THE SLEEVE DONE...A LONGGGGG 10 MONTHS SO IM HOPEING FOR IT TO BE APPROVED THIS TIME.IM WORKING WITH DR SCHUMACHER IN MIAMISBURG OH,GREAT GUY

Cleveland Clinic accepts medicaid (caresource) I had RNY with Dr. Schauer on 5/31/12. There are requirements and a 9 month dr monitored diet but they do cover it!