why the primary care doctor?

maybe wrong,but I think any primary care doctor is going to want you to spend some time seeing them,before they will just refer you for surgery the first time you ever see them. 

My PCP was against me having the surgery. I did everything through my surgeon and was approved. Now off to getting a new PCP.

But see with medicaid I have to go through a primary care doctor before it will be approved 

Right -- you have to see a PCP first -- and you are obviously super morbidly obese ---- but that does not mean that after 1 visit, your new PCP will automatically approve you for surgery.

You will have to go see the doctor and discuss it.

Then, your insurance may also require that you have 6 consecutive months of weigh-ins documented before they will approve surgery for you.

Every insurance plan is different --- the first step is to go see the new PCP and get things started.

Then get in touch with your insurance company, get (in writing) a copy of YOUR plan and what the requirements are.

You may need testing for apnea and other health concerns to validate co-morbidities to make coverage easier ---

You don't necessarily have to have a history of weight loss attempts under the primary Doctor's care. That will happen with the surgeon's office if needed. I would get the information from the insurance company as to their policy. I know my insurance company emailed me the link from their website. Second I would write out my own history of weight loss and gain and weight loss attempts. (Typed and easily readable) Also tell them you have considered it for a long time but didn't have insurance.  You have a high BMI and co-morbidities so it is not like you are in the borderline category. The Doctor may want to see you more than one time, but I would make sure you ask him/her what there expectation is... don't let them just drag you along. Usually in the first appointment they plan on extra time, so hopefully you will have a chance to express yourself.

The primary care doc is 'usually' more in tune with their patients than any surgeon, however yours is new.  You still want them to be on board with your aftercare needs.  As for getting around the weightloss intervention required, there IS no getting around it, so this would be a good opportunity to work with your new PCP on that and make sure that everything is heavily documented, for if one thing isn't right, even through no fault of your own, they could make you start all over again.

Went to primary care doctor today....he is doing blood work...I am on the extreme obese spectrum but I don't have any comorbities....it's ffustrating because they won't approve.without that 

Get a sleep study done. Many extreme obese people have sleep apnea. This would be a comorbity. Also many insurances do not require you to have any if you have an 40 or higher bmi. Please connect with the case worker and get a better idea of what hoops you need to jump through.

Got my blood work back..I have high cholesterol. ..but the primary care doctor just wants me to take medicine for it till may 4th...what now? I am extremely obese with 63 bmi and high cholesterol

Do you snore at night? Are you always tired? Then you may have apnea. Only a sleep study can tell. Also a case worker will most likely be able to help you figure out what you next best steps are and what you need to do.