In my surgeon's program everyone has to have 6 months supervised nutrition appointments, keep a food and exercise journal, apnea evaluation, cardiac clearance, psych eval, blood tests, EDG, etc before a date for surgery is set - it takes 6-7 months for all of that. Each surgeon is different, each state's medicaid program is also different. Medicaid in Illinois does not cover nutrition appointments and that $385 must be paid out of pocket up front - then the rest is covered - a good deal considering the bill is $61,000 total.