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New Here With A Few Questions

Hi. Im new to this site and I have a few questions. I live in Nashville Tennessee and I'm wondering if medicaid will cover a VSG surgery for me. Im diagnosed morbidly obese. Im 5'5" and 400 pounds. Im on Lisinopril for blood pressure, Lexapro for anxiety, Metformin for Insulin Resistance (thats right before full blown diabetes), I have arthritis in my knees and ankles and trouble getting around, and I suffer from nasty migraines. I've also been having trouble getting enough breath. I always seem to be panting as if Im out of breath, even when I dont do anything. I just moved here, but my doctor in Virginia had me on several different things over the last 3 years. Alli, Sensa, Atkins, low calorie/low fat diet, and nothing worked. I use to be able to drop 20-30 pounds over the course of several months (although it always came back) but in the last year I havent been able to lose anything. I'm wondering if Tennessee medicaid will cover the VSG surgery if my new doctor recommends it. I cant afford to pay out of pocket, but I'm ready, determined, and excited to get on this weightloss journey. I have 2 kids that i want to be around for. If anyone has any insight into wether Tennessee medicaid will cover the vsg, please let me know. Thanks so much!!

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I have no clue if that state will cover weight loss surgery. I do not believe my state does (Oklahoma). I am going to Mexico for my surgery (using my tax money). I hope you find out your answers. Your doctor will probably know the answers.

  • Author

I know Tennessee medicaid will cover weight loss surgery, but my doctor doesnt know which ones. Like I said, I just moved here. So I dont really know where to get the answers. Everytime I call medicaid I get transferred to different people and no one seems to know. Its really annoying.

I'm not in Tennessee, but what I think you should do is research online Nashville Bariatrics. There will be surgeons there that will work with you through the program. The first thing is to call and have them send out an information packet with paperwork stating everything they need for you to do. The surgeons office should be able to tell you what type of surgery Medicaid covers. After they receive a referral letter from your primary Dr. they will verify your insurance and get an authorization from Medicaid. I know this sounds confusing but basically you need to find a bariatric program in Nashville and let them walk you through the process. Hope this helps and doesn't confuse you too much. :)

Call Medicaid in TN - 1-866-311-4287. Good luck!! :)

  • Author

Thanks so much for the number!!! I will definitely call on Monday. Like I said, I know Tennessee Medicaid covers wls, I just need to find out if VSG is one of the surgeries covered. Thanks again!!

  • Author

I just found out the Amerigroup in Tennessee (medicaid) WILL cover the sleeve!!!! WOOT!!!

I need 6 months of documented medically supervised diet (got it), need to have a bmi of 40 or higher (definitely got it), need at least 2 health issues as a direct result of my obesity (got that and more), need a statement from my doctor saying that they approve of me having the surgery and feel its necessary (got it from my Virginia and getting it from my new doctor soon, I hope), need 5 years of records showing my weight to be morbidly obese (definitely got it), will need to get a cardiac and pulmunary clearance (dont have it yet but hoping to soon), I need to pass a psych eval (dont have one yet but will soon, I hope), and I need a physician referral to a bariatric surgeon (I will get that soon, as well. I hope)

So hopefully I can get the ball rolling really soon!!! I will be going to the Centennial Center for the Treatment of Obesity in Nashville, Tn. They are the only ones that do the surgery and will take medicaid. Ironically, I had my daughter at Centennial hospital 5 1/2 years ago when I lived in Nashville before, and I really liked that hospital. So Im pretty happy all the way around with things.

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