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I am so happy that you responded. It does give me more hope. I have called UHC to try to figure out what the requirements are and the only thing that they can tell me is that is is covered if its deemed medically necessary. I am afraid that for that reason alone I will not be approved. I only have a high BMI of 44. I have no comorbities. I do have PCOS but it can not be used. My PCP referred me to the weight loss program and I started going through all of the steps. I have even met with the surgeon. The only things I have left to do is 3 classes and upper endoscope. They do not want to submit that info for approval until I have completed all the steps on their end. The lady seems to think that they may require a 6 month diet so I have started that with my PCP and my first weigh in is the 29th. My last class is in November and they she said they are going to submit everything in October. I am just scared because I dont have any clear answers and the weight loss program has no information we are just kindly going by the seat of our pants.
Do you think we are waiting for nothing? How far have you gotten in you program? Have you been approved for surgery? Where are you from? I am sorry for all the questions but you are the first person to respond with any kind of knowledge. Thank you so much!
I feel your pain girl! The SAME thing happened to me. For my Bariatric Surgery Application, I NEEDED all of their requirements before they would even schedule me for an initial consult. So I called UHC three times and each time they told me they cant tell me because it needs authorized and my doctor would need to call. So the bariatric department wouldn't make an appointment with me because I didn't have the information, and the insurance wouldn't give me the information because I didn't have the surgeon calling in. Finally I made an appointment with my PCP and she was confused too. She didn't understand why she would need to call them, especially if the prior authorization would come from a surgeon and not her anyway. So she said they aren't going to make this easy and keep pushing them. So I called two more times and finally got answers! I got my paperwork filled out to submit to the bariatric department! Basically what they told me what that they have no restrictions or specifications about BMI, diet and exercise history or anything at all. Basically just need a surgeon stating that it is medically necessary and then they can submit for pre authorization. I was told everything would be covered 100%. I hope this helps! Let me know if you have any other questions! :)
-Mandy Leigh :)
Mason Ohio
Highest Weight/261
Surgery Weight/250
Current Weight/148
"All We Are Saying Is Give Peace A Chance "John Lennon 1940-1980~~
How did you get your insurance to approve the surgery?
Hi, I am in Cincy too. Where do you live? What hospital wll ou be operated in?
Does any one know if medicaid will cover the sleeve??? Or will they just cover lap and RNY.
There are many people, members and non-members, that come to the OH community wanting assistance to have weight loss surgery. One of the challenges many people encounter is "The Medicaid Maze" so we wanted to provide information about the difficulties for those people and from two leading bariatric surgeons.
We welcome your experiences by leaving a comment at the end of the article.
Hello Everyone! I'm so glad I found this forum! I've been putting a TON of thought into bariatric surgery and have been trying to figure out how I was going to pay for it on my own. I decided to see what my insurance would help me with ( Molina Medicaid) I'm glad I did!! I have a couple questions and any advice is GREATLY appreciated! Do I need to call my insurance first for any reason? Should I just make an appointment at the bariatric clinic or do I need to go to my PCP? My BMI is 43 and I haven't been 'diagnosed' I know that I have sleep apnea and high blood pressure. I had complications with my pregnancies due to high blood pressure and it's stayed high. I am in Columbus, OH so I am open to advice on bariatric drs/locations! thank you!!
Your welcome. Yes there are several different ones, don't get care source when/ if you choose, they take the longest as in a 9 month supervised diet. booo. I have 4 more months to go, but all my testing is for the most part have been/ is done this month. thankful to get all that out of the way. lol. Just thank of all the stuff you could do with that money you have saved if they pay 100%. However you might want to hold on to that savings for plastics down the road. 
~Take a second chance, give a second chance~
