Straight FL Medicaid requirements? ???

Heavy Duty00
on 5/17/14 11:17 am

Girl,  I have clue what I'm doing anymore. Lol! My whole insurance, job, medicaid, self pay situation is confusing.  When I had medicaid (health ease) I was going to Dr Ramos.  I talked to them last week and now they don't take share of cost. Maybe I will call UF and see what's up. 

shall0927
on 5/17/14 11:20 am

Is he with Uf? I'm seeing Dr Ben David. Idk what all medicaid they take but yea call Andrea white....just don't tell her I sent you. I'm sure she thinks I'm a pain in the touch, I've called a thousand times lol

Kdiva
on 5/22/14 3:54 am - Margate, FL
On May 17, 2014 at 6:17 PM Pacific Time, Heavy Duty00 wrote:

Girl,  I have clue what I'm doing anymore. Lol! My whole insurance, job, medicaid, self pay situation is confusing.  When I had medicaid (health ease) I was going to Dr Ramos.  I talked to them last week and now they don't take share of cost. Maybe I will call UF and see what's up. 

Have you had any luck with finding a doctor that accepts Share of Cost? 

Lovenewlife
on 6/20/14 1:23 pm

Hey I am new to Florida and I am getting Humana as my Insurance through medicaid. and I was wondering what their requirements are.... Thanks in advance... 

Kdiva
on 6/20/14 1:50 pm - Margate, FL

This is straight from my Humana verification of benefits when I had Humana/Medicaid: 

1. Must have a Body Mass Index of 35 or greater

2. Must have at least one co-morbidity related to obesity

3. Must have been previously unsuccessful with medical treatment for obesity 

DS: 5/28/14

HW: 310

SW: 302

CW: 160 ( 1 year post-op) 160 lbs gone

Ju-Cee
on 6/27/14 1:51 am, edited 6/27/14 1:54 am

Hello...Just wondering if any one has found out if medicaid requires 3/6 months of supervised weigh ins with your pcp?? I have years of medical records that shows I have attempted to loose weight.  I even had a surgery date when I had bcbs thru my job...did all that was required but I had to leave work. So now I have medicaid and I don't want to do everything all over ( . And you know when you call medicaid you get 10 different answers.  Just wondering if any one has any info.

Kdiva
on 6/27/14 2:44 am - Margate, FL

If it's straight Medicaid. .......Yes you need 6 months. You can also use your supervised visits that you already have. If you're on a HMO plan through Medicaid it depends on what their requirements are. Hope that helps. If not please feel free to ask questions I will answer them to the best of my ability. I just went through the hoops of Medicaid.

DS: 5/28/14

HW: 310

SW: 302

CW: 160 ( 1 year post-op) 160 lbs gone

rcgarcia80
on 9/28/14 2:56 pm - largo, FL

Hey there :) Im also looking in to the wls... I dont have a pcp, however, ive been going to my obgyn for the past yr becuz i was pgnt and had high sugar and hbp and he wanted my weight under control...could i use that as my 6 months waiting oeriod? or does have to be with my pcp? thxxx

Ju-Cee
on 6/27/14 2:58 am

Thanks. ..if you don't mind me asking what hoops? I will have to choose a plan under medicaid soon and 3 out of the 4 plans said I didn't need the weigh ins..just medically necessity from my pcp. I have done the 6 months about 4 months ago..I don't want to do it all over. I'm not trying to bypass what's needed but I would like to use what I did. How are you feeling now? I'm happy for you..I can't wait

kimburlee89
on 7/9/14 2:39 pm - hernando, FL

I have prestige heath insurance through medicaid - they required 6 months weight loss - i also had to take a nutrition class (but that might of been my surgery doctors requirement) they doctor also did a scope to make sure my stomach was okay - then they submitted it to my insurance and the insurance required i see a heart doctor and a lung doctor for clearance for the surgery - It probably depends on what insurance you have but usually i hear its 6 months weight loss - but it just depends on the insurance and sometimes differant doctors require differant stuff. I just meet with the lung and heart doctor and got their approval so now im waiting to hear if the insurance approves it - im so excited !!As far as i know prestige doesn't require anything else but the trying of weight loss - i dont have any health issues that i know of because of being over weight i know some insurance require you to have complications from the obesity . 

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