Medicaid Anyone??

Did anyone have Ohio Medicaid for their surgery? If so how long did it take for your answer and were you denied at first? If so what was your BMI? I am going on my 3rd month of waiting, they say anywhere from 6 to 12 months to hear...I am just scared I am going to do all this waiting just to be denied... My BMI is 47...I have sleep apnea but no other major problems...Leg pain (knee,heal and ankle) so bad I haven't been able to work for 3 years..High fasting glucose levels but other blood sugar levels are great..No high blood pressure....How can I be so healthy and feel so bad and tired???? I know this waiting is the hardest part...I have always been a patient person UNTIL NOW!!!!!!!!!

Hi Deb, I know you don't want to hear from me again. But I will answer anyways Yes - Medicaid 6 months - and only cause my PCP's office inquired BMI - 53.9 They told me 45 days, took 90, but didn't receive that word till the 6 month mark. That was last year also. I'm still praying for ya girl!

Actually good to hear from you! I am just going CRAZY! No one wants to hear about the surgery anymore but I can't think about anything else. I try to keep mymouth shut but I always seem to say...If and when I get this surgery.....It drives me nuts to know that one day I may feel GOOD again. I want to do so much but when I try to get up to do it I just can't believe my body is so heavy and every movement is so painful....What also sucks is that the lady that does all the insurance inquiries and stuff left the doctor's office and I get scared that I am going to get lost in the shuffle..... Thanks for listening!

Just keep on them. dont give up. I started this journey back in 99 . I gave up my fight. I finally got it 3 weeks ago. Just keep on them like a fly that will not leave them alone. Someone will help you sooner or later. . I dont think bothering them will hurt your case. You need to stand up and be heard. They will give in Take Care Barb

Debbie, We are always here to listen to you!! I kind of went through the same thing when my Dr up and moved out of town. My records and the office staff disapeared for a long while and I felt I was never going to make it to the operating table. But after a very long time it did happen, and it made the wait all worth while. When you have to work so hard to get the approval you are so READY for the surgery and have the time to get as much information and begin implementing some life changes that will help you post op. My biggest suggestion is increase your upper body strength. Get some little weights and just keep lifting them every day. It will help you move yourself around easier post op and get in and out of your own bed easier when you get home. Start keeping a food journal and it will amaze and horrify you to see how much you are really eating. Just dont give up and just know we are here for you. Hugs Laura

Laura, What good advice. I pulled a muscle at the hospital right where my heart is. I thought I was having a heart atttack. They ran alot of test. It was a pulled muscle from pulling myself up. It was so hard to get myself pulled up. Take Care Barb

I know about the pulling yourself up. I have had 6 C-sections, the last being a year ago and i remember having to pull myself up and hold onto my belly at the same time. As for the food journal...I AM scared.. I have already given up carbonated beverages (since January I have only had 6 cans of ginger ale, I was weak and craved it a few times), and had given up bread until a few weeks ago (Daughter bought me a Subway sub and that started the craving again****ep telling myself to try to lose something now just in case I get denied and will already have a head start....I don't have a diet history like most...I have never been able to lose over 30 lbs on a diet my whole life...I lost 100 lbs when I got divorced but that wasn't from diet that was from lifestyle change but even then my lightest weight was 225.. And now I have gained 70 of those pounds back...I AM SO READY FOR THIS! Thanks for taking the time to answer!

Debbie, Our stories our so similar its scary. I got divorced 4 years ago and I lost 90 pounds and got down to 205. I was walking 4 miles a day . I called it the "Heartbreak diet" then I met the man of my dreams Rick from Massachusetts. We had a wonderful year and a half together and when we broke up, instead of going on the heartbreak diet, I went on a year long Binge. I gained so much weight. And then I developed the cushing syndrome and had the hysterectomy and the rest is history. I got myself fattened up to 310 pounds in a hurry. I know if I hadnt had the WLS I would of ended up gaining and gaining more. I Thank God every day for helping me to be patient and wait and wait for approval and now that I have this tool to use it to the best of my ability. Debbie, I feel so incredible and NEVER want to go back to where I was again. I pray to God every day he gives me the strength to exercise and eat right. Even with the tool, I know I cant do it alone. I need God, my family, and the support of this WONDERFUL GROUP. Thank you all for being who you are and contributing to my success. I couldnt of come this far without you all. Love and Hugs, Laura

Here is what I have learned about Medicaid approval--My sources for this information are Dr. curry's insurance gal--Tracy and from a friend of mine who is a caseworker with Ohio Medicaid. The wait for a response to your application for approval is running 8-10 months. BMI should be 50 or above--They will tell you 40--but 50 is the more accepted number to gain approval. This doesn't mean absolutely no for a lower bmi, but ...who knows--we are dealing with a government agency here, and they are known to be unpredictable. At least 2 major comorbidities--high blood pressure,diabetes,sleep apnea with the need for a cpap. GERD is not considered, and arthritis usually is not considered. I guess because--while painfull--it is not life threatening. I only tell you this to inform--not to discourage. Keep on your doctors office. Make yourself a nuisance. Call medicaid often--The squeeky wheel gets the grease.

My experience was about 3 years ago, I'm sure they are handling more cases now. My PCP sent the letter in May and I heard back by the end of July. I was over 500lbs and had been supervised by a doctor trying to lose weight for over a year. It was the first time my PCP had written a letter for such approval and we never called and checked on it's status.