Medicaid and WLS

 Has anyone delt with Medicaid recently for WLS.  After I have started the WLS program I am now told that they believe my insurance is going to require a 6 month dr supervised diet plan.  I have tried contacted medicaid several times with no luck.  NO one knows what I am talking about.  The WLS Center said they that lately they have been getting feed back on some patients some requesting the 6 month diet and some just want 3 year showing obesity and others coming back with no problems at all. They said Mainecare is very unpredicable right now and they want to play it safe.  My PCP is not impressed about this at all she says it is a waste of time and money and nothing but a big hold up.  She said why cant I just write a letter.  I said because they said they are requiring a 6 month diet to be in the safe side. My PCP had a point and her point was ok lets start the diet appointments but in the mean time get everything else done and then have them submit to insurance if it comes back that you need to continue on with the 6 months then we continue.  She said I dont want to get to the end of your 6 months and then they deny you or want something else.  Anyone out there have this happen to you?

I have to do 6months and my doctor said the exact same things that its about seeing if Your consistent and stay on the plan not even so much if you lose the weight! Do YOU know when Your 6months is up?? Mines is in April!

Well it will probably be April  unless Mainecare will say they will except Sept and Oct office notes even though I was at my dr for other reasons not just to discuss weightloss even though the office notes talk about my obesity and exercise, all my health issues, ect.  If they don't except them then it will be April.  Also I called Mainecare (medicaid) again today and they told me that they do not require me to have a 6 month dr. supervised diet program but if the WLS center is requiring me to do it then they said just do it.   I did ask them if when I finish up with all of the other appointments and in the mean time keep doing the 6 month supervised diet plan. She said if you are done before April go a head and have them submit and if they come back that they do indeed now require the 6 month then you can just finish up with those visits and then resubmit.   Have you seen the WLS Center yet and started some of your appointments?

ok cool, I was wondering why my wls center wanted me to do mostly all my pre-op test! maybe they will submitt my information too, how do you find that out? do you think i should ask the insurace company (medicaid) or the wls center?

:) aisha <3

 Aisha if you are going to be around today message me on here and we can talk since I will be home all day today.  Talk to you soon.  Kim

I'm in my fourth month of 6 month visits for medicaid. It's been good for me though, I have A LOT of weight to lose. it's also given me time to work on my emotional eating and habits. Good Luck!