Question:
I have Medical Assistance (State Aid Insurance) Is it hard to get an approval?

I have Medical Assistance (State Aid Insurance) I have severe sleep apnea. As the doctor stated when I got my results and CPAP machine. I have acid reflux which my medication can hardly help. I have asthma as well. I weight 340+ and I am only 25. I have been researching this WLS and I would really like to go through with it. Just wondering about calling for an approval with my insurance this is pretty much my last hope. I have tried weight watchers and followed the program faithfully and didnt work for me like it does with others. Just wondering if others had any problems for getting a yes through a state funded insurance program?    — Candi Smith (posted on September 1, 2009)

September 1, 2009
I live in Kentucky. Our state insurance is called Medicaid. That is what I had and I had no problem. The conditions that you mentioned should help you qualify. The state would rather pay for the surgery than to have to pay for a lifetime of meds, etc...for obesity related conditions that will develop. I'm just glad that you are doing it at a younger age, instead of waiting for more problems to arise due to your obesity. You are making the right decision. I had RNY on Dec. 30th, 2008. I am down 95 pounds. I, too, started at 340 with my journey. Having the surgery was the best favor I have ever done for myself. I only wish I could have had it when I was younger like you. I am 43 and, while I am happy with my loss, I know that if I had it when I was younger and my metabolism was higher then I'd have lost even more by now. I say GO FOR IT! No matter what it takes. I don't think you're gonna have a problem getting approved...but, nevertheless...don't let anything stop you! Good luck and God bless.
   — PaulaJ

September 1, 2009
Hi Candi, I also had Florida state medicaid...I checked it out first and was told I would need to change to Staywell/Wellcare ...I did and did all the pre-reqs and had my surg 7/1/08...had the most wonderful DR. at a great hospital here. I did have to go aways for him but he was/is worth it. Just start by calling the ins. office and check out the Drs that except your ins. and go for it. Best of luck...
   — tootsie52

September 2, 2009
I have state ins. its key stone mercy, i live in Philadelphia ,PA. i called my insurence and ask them do the cover the surgery and their answer was (YES) so i went and found a doctor i liked and made app. with him and it only took me one week to get my approvel .my surgery date is sept 22. if have any questions email me.good luck
   — sunrise78

September 2, 2009
I had State Insurance just do what u need to do there are some loops to go thru , most insurances require 6 month dr visits make sure ur dr documents diet and weight and excerise 6 month in a row and you should not have a problem I had my surgery October 31 2007, had Plastic Surgery Aug 5 2009 and they payed for it to i am doing well and Good Luck to u if u want to talk to me about it look me up on Yahoo my yahoo id is angelscentt
   — angelscentt

September 2, 2009
I have medicare and medicaid in CT. My gastric bypass was covered.
   — Lynnmon