My Story on Getting Approved for WLS w/ Medicaid

I am really not too good with posting on here much due to time and not having a good computer.  But I have posted much about my story over time with medicaid under my profile to try and help those who like me in the beginning was getting absolutely no where.  Especially when on my first PCP I started with had no idea how to contact them correctly or write a letter and send records (she just sent a 3 sentence note and no records).  We waited forever and wondered why there was no responce until I found out what she did when she gave me a copy months later. 

Anyway, I have been through quite a process.  I hope my story will help and give an idea.  Keep in mind it will take time and to never give up!  I am still in the process but the ball is rolling!  Best wishes to you all!!!

Hugs,

Debbie  

Debbie, I just read your profile. I hope and pray that you can have your surgery this year. Way to go for hanging in there, and filing the appeal! Hang in there. I am confident that you will be successful.  It is worth all the struggles you have been through! Keep us posted and let us know if you need anything along the way.

Thank you so much for your support.  I would like to add you as a friend as well.  I believe it will be worth it all when I reach my surgery goal.  I have wanted this for sooo long now.  We have no support groups over here.  Reaching out is what I plan on doing until I now more on what to do from the doctors from there.  As for helping people along the way who are in the same boat will also help me as well.  I feel putting my story out there will help others not to give up.  This is a great forum, we all should take full advatage of it.

Thanks again!

Debbie

I to have Medicaid, and I've been denied 4 times. I'm not giving up! I refuse to give up! I got a lawyer from North West Justice here in Spokane. Hes just waiting on some paper work from me then he will decide to take my case or not. I have spent much time and effort on sending 100+ pages of documentation that I received from doctors and from my personal struggle with my health conditions.

I'm taking the time to read what you have been through Debbie, and hope I can gain a better understanding of what you had to go through. My doctor is sticking by my side even though she has no idea what to expect. She is learning about the medicaid process just like myself. I'm trying my best to keep her informed and printing out the proper codes and WAC rules.

I'm saving the "Exception to the Rule" law as a last resort. I'm going to keep fighting. I'm praying that the lawyer will help me through this....

Thanks for listening and good luck
-Billie Jo

(my profile is old and has not been updated with current information)

So glad that you are not giving up!  Four times may seem like a lot but now you have a lawyer!  Good girl!  It is so importantant as you know to keep copies of everything. 

Getting letters from every doctor you see, and telling them your story.  I want everyone to know *****ads this that when a doctor sends a specialist you see  a report to your doctor, have him send you a copy as well.  And have him or her address your obesity as a problem to your issue.  It will help you in the end for approval. 

In the beginning, the things that took me so long was getting documentation, having the wrong doctor, learning what I need to do, finding another (which I wrote a letter to about my obesity asking for her help in the beginning), educating us both through the process, and most of all having a advocate to help me through this denial was huge!  Without her, I probably would have been looking at future denial letters.   I owe so much to her.

I know how much obese people need this.  I posted my story to try and help.  I hope it gives many some support.  I hope yours will touch others and make people think not t o give up. 

We are talking about your life people!!!  Go after your goal and fight and get your wls no matter what!!  You take a day at a time and you all can do it...God Bless!

The best of luck to you Billie Jo.  Keep me informed.  My prayers are with you! 

Hugs,

Debbie

Your struggles are so similar to mine Debbie, I had a Doctor that left me hanging 2 years ago. She failed to tell me to get back in contact with medicaid so I can proceed to the second stage.
Then I lost my medical and now I'm back in the same situation, but with more co-morbid health concerns. I've been on medication for 2+ years and medicaid seems to think physical therapy and pain management would be a less risky outcome. I've just finished another session of physical therapy making that 5 attempts or more I lost count. I've been on medication for pain for well over 2 years and my conditions seem to be getting worse and not improving. That means all my medication/pain meds have increased along with the pain and other health concerns. But I'm sure your all to familiar with the whole hair pulling thing.

I have a small favor to ask? I'm having troubles on approaching my specialists (my Knee doctor and my physical therapist) and asking them for a letter of recommendation? Do you think you can help get me pointed in the right direction with a sample letter or something?

Thank you very much for sharing your story with everyone.

-Billie Jo

Hello again!  I too am on pain medication.  I have severe back pain.  My weight doesn't help.  Especially carring a large stomach and large boobs.  I also was thrown from a car several years back.  My back has never been the same and as my weight had incressed, the pain seemed to have got worse too.  I do have osteo-artritis in it as well.  Funny thing is when I seen that back doctor and had asked him for a letter, he just wroter a sentence about my pain on a prescription pad and signed it.  It still was something that helped and he still had something about wls sugery would help me in my records.

Physical therapy never really helped me much.  Weight takes a toll on a persons body and that was that.  I just need to lose weight and a lot of it.  WLS is what will benefit me and people like you.  Lugging around all this weight is hard on your body: your organs, your joints, etc.  We are a ticking time bomb when you think about it.  Sadly, many people have died waiting to be approved.  It should not be that way. 

I would love to show you my letter I wrote to my doctor.  But there is one problem...I did it a few years back on a older pc that I cannot get on.  I am sure my doctor would have a copy in her files but i have found another way I can still help you with sample letters and others who may not know that this is available!  Go to the search bar on this site and type in " letter of recommendation samples" and you will see what OH has done for sample letters for us all to learn from.  What a great site we have here.  We just need to reach out to each other and ask questions and reach out for support.  I feel bad that mine isn't available, but I think this is so much better. 

I read your profile...love what you did and song!  I would like to figure on how to do Kellie Pickler's "I'm On My Way" on mine.  You have some great advise on yours.  My dietitian has helped me so much two years ago and right now.  Keep up the great work!

Hugs,

Debbie