New to this site...Anyone with Prestige Health Choice (Medicaid) I need advice please ...

Catalina87
on 8/15/14 5:08 pm - Clearwater, FL

I just began my journey for wls and new to this site... Im planning on getting the roux en y gastric bypass at tampa general hospital with Dr Murr who from all the research I have done see very positive things about him....The only step I have completed so far is going to the information session where I learned alot of things including the steps I have to take for my insurance to approve my surgery. So far I have alot of things to get done I scheduled my first visit for my 6 months supervised diet next week which my surgeons office provides. I haven't had a PCP because i have been seeing my OBGYN for over a year now since I have a 10 month old but I did make a appointment with a PCP who is in the same medical group as my surgeon I have my fingers crossed hoping it will be easy to get a referral for my surgeon this way...

 

I am 6'3 and im about 360 pounds which put me at a bmi over 40...45 to be exact I have joint pain shortness of breath and its getting hard to keep up with both my kids my oldest whos about to be 7 and my youngest 10 months old.

 

Well enough about me basically what im trying to find out is if anyone has FL medicaid , what are all the requirements that I need , what are the chances of my insurance approving my surgery having medicaid and prestige as my hmo and how long did this whole process take including the 6 months.... Im so excited to be going through this journey and Im hoping for the best   

 

Thanks In advance

Kdiva
on 8/21/14 5:58 am, edited 8/21/14 5:58 am - Margate, FL

If you've discussed your weight with your gyno Dr that counts toward your 6 month visit. I have Medicaid surgery was  5/28/14 & used a combination of 3 Dr's for my 6 visit. As soon as I completed the requirements I waited less than 1 month & had surgery 

DS: 5/28/14

HW: 310

SW: 302

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

Catalina87
on 8/21/14 8:34 am - Clearwater, FL

Thank you so much for the info I'm going to get my records from my obgyn and hopefully they will count towards my 6 months thanks again and congrats on you're surgery! 

rcgarcia80
on 10/15/14 2:20 pm - largo, FL

did that work? obgyn letter?

Kdiva
on 8/22/14 1:39 am - Margate, FL

As far as what your requirements will be. Different surgeon have different requirements. But Medicaid required: 6 month supervised PCP visits, psyche clearance, letter of medical necessity 

DS: 5/28/14

HW: 310

SW: 302

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

Catalina87
on 8/22/14 6:48 am - Clearwater, FL

Thank you so much I just have one question who does the letter of medical necessity have to be from pcp or surgeon?  Thanks in advance

Kdiva
on 8/25/14 9:40 pm - Margate, FL

Your PCP does the letter of medical necessity 

DS: 5/28/14

HW: 310

SW: 302

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

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