Hello, I did the six months supervised weightloss I finished every requirement during that time.  We submitted my stuff June 9 I had and answer the next week. As long as you do everything that's required they will approve you.

I currently do not have a primary care physician. Any suggestion on a physician that will approve for me to have wls 

I've lost my way as far as working out and staying on track.  I need some LOCAL motivation.  Is there anyone who wouldn't mind working out or just being one another's shoulder.  I'm at my wits end.

Hi Shayna,

I thought the coverage was excellent and had zero problems getting approved.  I know you had to either have a BMI of 35 or higher with at least two comorbidities or a BMI of at least 40 without any comorbidities.  The first thing you do is call a bariatric program and get scheduled, usually the first thing they require is a seminar.  After that they will schedule your first appointment.  Molina required a cardiac clearance from a cardiologist, some lung function tests whi*****ludes a sleep study and then a clearance from a pulmonologist.  There was some blood work as well including a test for drugs and alcohol.  Those were all easy and had them done in a month.  They usually make you attend one support group and then a nutrition class as well.  But those can be done any time before surgery. 

The thing with Molina is that I was told a medically supervised diet must be through a doctor.  Not through a program like Jenny Craig, etc.  Honestly, I am glad I had a six month diet because it really helped me to be successful post op.  It gives you plenty of time to learn a ton, get used to the life you will be living, and make some changes before surgery.  And it will go by quick!!!  What you do is just see the surgeon (in my case) and the nutritionist each month for six months.  Your first visit will count.  After your sixth visit they will submit to insurance!  I used Mercy Healthy Weight Solutions in Fairfield, Ohio.  Its outside of Cincinnati.  My surgeon was Dr. Dahman who was amazing!

I did not have any denials and was approved in 24 hours after it being submitted.  I had a super positive experience with Molina!  I have now lost 183 lbs in 14 months and trust me, it was the best decision I have ever made!  Good luck!

 Hi misty! I am currently trying to get the ball rolling for wls. I live In ohio and also on Molina. I've been reading mixed things about coverage. I called molina and spoke with them about coverage and they said ya they will cover it if I met the requirements. Which surgeon did you use? Did you get any denials prior? What did you complete prior to prior auth being submitted? I did jenny craig 6 months ago, would that count as my 6 month diet? Who does the diet need to be supervised by? Sorry for all the questions, I just seen you were done pretty quick and seem to know the ropes :)

-Shayna