Question:
WHAT'S UPWITH MEDICAID?!

I WENT TO THE DOCTOR FOR MY FIRST VISIT 2/25/02 AND WAS TOLD THAT SURGERY WOULD BE THE BEST OPTION FOR ME. I'M IN COLLEGE AND HAVE MEDICAID FOR INSURANCE...HOW LONG DOES THE "OK" DRAG OUT?! I THINK I'VE GAINED 20 MORE POUNDS! PLEASE HELP! [email protected]    — REBECCA J. (posted on June 25, 2002)


June 25, 2002
it depends on ur state. im in ky and i was approved in 3 weeks but they only approve the open gastric so check out ur state sorry i couldnt do more but u might get a better response if u tell which state good luck to u
   — amanda W.

June 25, 2002
Well for me it was nine long months of fighting. But before I went to see any doctors about WLS I changed to Blue Choice Option, which is for people on Medicaid. So the aproval had to come through them and they were real,... ahem, I can't say the word here. But they were very difficult.
   — Danmark

June 26, 2002
Hi, I have been dancing around with this surgery and Medicaid longer than I wish to recall, my PCP will refer me but I have to find a Dr. which most of them don't accept HMO Medicaid but I did find out the day b4 yesterday that the insurance co wants to seek approval first -- so that might be an option, just make sure your PCP is on your side and your battle is half way won...I hope I helped if not feel free to email me. Yolanda
   — Ms. Slimmie

June 27, 2002
hey girl! you ganna be fine. i had medicaid and got approved after the first attempt. it took 2 in a half weeks and i got a call to schedule to meet my doctor. after the call i had 3 more calls the same day from them and my doctor and he even asked me when i wanted it done. 1 week and 5 days later i had a new birthday and my miracle begin. to begin i was about 370. i got the surgery on 4-11-02. today i am a much sexier 293.5 ---and chillinnnn. i feel good- that is all i can say. i've lost 73.5 pounds in these past 2 months and i'm trying to loose a whole 100 pounds by the 31st of july. someone said i couldn't do it so, i'm up for the challenge. anyway- email me anytime and i'll be blunt with ya and give you the whole scoop. good luck girl. you ganna be just fine.
   — Janvielle F.

June 28, 2002
Each state is different, so I'm not sure that my experience will help you. In NC, the surgery must be medically necessary, and you MUST have co-morbidities. I had no trouble getting a referral from my PCP, however my surgeon is the best one in NC, and you can tell it by his waiting list! I spent 7 months on his waiting list before my first consult, then had to have preliminary tests done before they could submit for insurance approval. They told me ahead of time that NCM- was very good about responding quickly, usually 5-14 days. They approved mine before 14 days. Also, my surgeon said that in the 25 years that he has been doing this surgery, he had only seen NCM- refuse 1 time. I'm sure that a lot of that has to do with his screening process, because if he doesn't think that you're a candidate for surgery he won't accept you as a patient, and if he doesn't think that your insurance will pay, he tells you that upfront too. Now I'm rambling... hope this helps.
   — Tracy P.




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