Question:
DOES KANSAS MEDICAID COVER ANY WLS?

   — LaDessa D. (posted on October 28, 2005)

October 28, 2005
CMS guidelines make it possible for Medicaid to cover WLS in any state. They do not cover every procedure, but they cover the majoirty of the common, safe procedures. They have to follow the same guidelines as the community, so BMI and co-morbidities are still improtant. They even cover revisions if you need one down the line.
   — nursenut

October 28, 2005
I apologize, now that I have read your profile, I may be able to provide a more complete response. First, are you a Qualified Medicare Beneficiary (QMB)? If so, you have rights under Medi-Care and Medi-Caid. Per Supplement 3 to Attachment 2.6-A of HCBS-PM-85-3 Title 22 for the State of Kansas , WLS is not listed among the the excluded procedures. While the final decision is up to the Division of Medical Programs staff, you can always appeal the Customer Service person's response. Under Medi-Care guidelines, WLS is covered.
   — nursenut

October 29, 2005
It will depend on the state in which you live. Have you looked in your state's insurance database? I would check there first. Each state regulates it's own Medicaid program within the Federal Guidelines. I know that when I lived in Oklahoma, Medicaid did not cover gastric bypass surgery. You may remember a story with Carnie Wilson and those two obese twins who lived in Oklahoma who had their surgery donated to them. Here in Florida, Medicaid does cover the surgery. Oklahoma may have changed, it's been a couple of years since I lived there. Good luck!
   — Shayna T.