Medicaid ???

Does anybody know what the heck is going on with Medicaid? I called Molina and they told me that as of 1-26-04 DSHS does pay for WLS. Then I called the # on the back of my med coupon and they said that Medicaid doesnt pay for WLS anymore. I called Dr. Shrock's office in Spokane and they said Medicaid was making all sorts of rules for the surgery and that you had to go on 6 mos. of their diet before they would approve. She proceeded to tell me that I had to call back in a month because things werent settled yet. I then called Dr. Lauter's office in Kirkland and they told me that they do pay for it. I have an apt. with Dr. Lauter on Thursday and I'm really freeked out. I don't know what to expect. I know Medicaid can be hard to deal with but this confusion is too much. Does anybody have info. for me?

Holly- I live in Oregon, and my doc here tried to get the surgery pre-approved by Medicaid about 7 months ago.... Mind you I am fairly Medicaid savvy (used to work for a medicaid broker) and did my research that told me WLS surgery IS covered by Medicaid... I went and checked it out via the line item listing on their own website.... my doc tried to get it approved w/in a month and they denied it saying "it is not a covered service"..... I knew that it WAS- based on their own info! I could have fought it, I suppose, butl I knew it was going to be a major battle, and didnt want to waste any more time or energy on it, so I got a job w/benes that DO cover WLS. I had a consult w/Dr Lauter 2/11/041 - I really liked him....we are waiting for approval now... I cant stress enough how important it is to be prepared... have as much of the needed paperwork, records, lab results, documentation of co-morbidities at that appt. with the surgeon... You can be sure Medicaid (if they will pay for WLS in your state) will demand documented weight loss attempts and co-morbidities. Your PCP/family doctor can be your best friend or your worst enemy in this process.... did your doctor refer you to dr. lauter? I always recommend to others here that you take a look at the link on this website to "Your Journey"... I have followed a lot of the steps, and it has really streamlined the process we all have to go thru have WLS- unless you Self Pay. Anyway, make a list of questions between now and Thursday and ask them of Dr. Lauter, he is very easy to talk to appreciated the thought and preparation I had done before our consultation. He answered all the questions I had and I went to one of the seminars at Evergreen later the same night.... There were 2 women there who had already had WLS, one with Lap Band and one with Bypass surgery... they were completely candid, and I got a lot of really usefull info there as well.... Keep me posted on your progress.... and good luck with Medicaid, prepare for a battle, though.... and grow some thick skin... you may need it... but just remember, its your life you're really fighting for, and you can make it happen...... debby

Thanks so much for your info. Every little bit helps. I saw Dr. Lauter last week and they seem to think that it will be covered so thats a step in the right direction. I worry about documentation though, my Docs in the past havent taken my wt very seriously and documentaion is scarce. I just hope the comorbidities I am dealing with are enough to get the job done. We'll see!

I don't know about Medicaid, but MediCare does pay for WLS. I called them and had them send me a letter stating so. Good luck and let me know what happens with Molina.