Question:
Appealing. I would like to know if anyone out there has had Medicaid as an insurer. Furthermore

has Medicaid approved any reconstructive surgery? Denied any surgey? Has anyone had to appeal a denial from Medicaid? What were the results? What surgeries did they agree to cover? What were the conditions under which you got coverage. For what reasons were you denied. What did you do or say differently in the appeal? Although I have not had bariatric surgery, I lost over 180lbs. on my own within the last 8 years or so through total lifestyle change. I have lots of hanging skin and Medicaid is my option at this point.    — clitha M. (posted on October 19, 2001)

October 19, 2001
I have no personal experience with Medicaid. But, my sister lost 150lbs. in one year by dieting and exersizing. She went from 280lbs. down to 130lbs....so you can imagine how much she needed some reconstuctive work. She asked for approval for breast, stomach and buttucks. They denied it all as cosmentic and she appealled....with photos and letters from her pcp, her psychiatrist and the plastic surgeon. They approved the breast work and the stomach work and she had her surgery six months ago. Sne looks absolutely terrfic. They wouldn't approve the butt lift; but my sister says that that area is tightening up on it's own. The whole process from the original request for approval...throguh the appeals (...including Medicaid's losing the paper work twice...) took well over a year and contributed to my sister's clinical depression.
   — [Anonymous]