Have Questions About WI Medical Assistance/medicaide

Hi.... I'm working on getting my WLS. Currently doing a 6 month supervised weight program with a registered dietitan. Up until very recently, I was on medical assistance and a badgercare HMO (Comp Care). I now have straight Medical Assistance. I'm disabled, so no hmo or anything like that. I was just wondering if anyone had dealt with them, how long the approval process took, what things they required, etc.... I originally got a lot of information from Comp Care, have been following everything I was told to do, but now I'm wondering how things will work with medical assistance. I've tried to call them and ask about the requirements, referrals, all the other necessary things, and I just keep getting told I have to have my pcp call, that they can't talk directly to me. My pcp has called them, after I wrote down the questions I needed answers to, (he hasn't dealt with anyone on medical assistance getting WLS in a long time. I'm in a very tiny town) and they didn't tell him everything we needed to know and half of what they did tell him, he couldn't make heads or tails of. Would just like to know what other people's experiences have been. Thank You, Bliss............ ~Shan~

Hi Shannon, I can tell you that the laws about wls have changed effective 01/01/06 with medical assistance. Before January 2006 all you needed to approve was thaat you were obese with other issues or that you were severely obese to morbidly obese with a bmi 50 or over. now you need to have major issues and be severely to morbidly obese just to get your file looked at. I have a friend who has been declined twice already. she is over 280 lbs and 5'9. she has medical issues with her back, high blood pressure and has a large hernia. this was not enough to get her wls. she is now scheduled for a sleep study on July 10th and she is hoping to have sleep apnea. We are hoping that this will get her through. I had wls in December 2005. I had a bmi of 51 and I had no problems getting approved. If you have any more questions about me or my friend please email me. Yolanda

Hi Yolanda.....Thanx for responding I currently have a bmi of 53, sleep apnea, arthritis, awful back and hip pain, big ol' hernia , borderline hypertension, pre diabetes...the list goes on ad nauseum....lol I just can't seem to find out if the requirements are the same for straight MA as they were for my MA HMO. I hope you're doing well on your journey, and that your friend gets approved!!! Bliss..... ~Shan~