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Medicaid Child Health Plus

Hey there, well i'm 16 and under fidelis child health plus insurance and i've been mulling over weight loss surgery after my back pain and asthma started to affect my life on a daily basis.I researched and decided i really don't want any surgery but VGS, but recently i heard (through the grape vine you know) that medicaid finally approved it. I think this is a sign from god because as soon as I was sure about it the surgery was approved my medicaid.

but anyway I'm really nervous because I don't know if the hospital i want my surgery done at will operate on a minor, and i can't afford to cover more than $2000 dollars, my parents can't help me they don't have much money, but i have a job so i can cover a little myself. I want it done at Mathers Hospital in port jefferson, NY. I don't know if anyone here can give me answers on what my chances are of getting approved.I sent an email to my insurance about it, and i went to my PCP with my mom and the doc tried to convince me i wasn't that big, pshaw.However she did make me get a bunch of bloodwork done which i am still waiting for 2 weeks later, how long does that usually take?Then I can have a consultation with the surgeon guy at Mathers. I am morbidly obese btw. I'm just kinda worrying a lot these days because I really have my heart set on it and i don't even know if it's possible for a minor to get sleeved. I know lapband is pretty common in teens, but i don't like the idea of lapband. Any kind of answer at all will be appreciated. Also I have SAD will that help me? or will it hurt me because they'll think i'm crazy?I manage it very well.

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  • Author

i feel like i should add that my dad is a type 1 diabetic and so was my great uncle. My grandmothers both had breast cancer one died at 30 the other survived. I don't know if family history will help with anything though

  • 4 weeks later...

I didn't realize we live basically pretty close to one another. I live in Mineola on Long Island. I have similar insurance to yours....United Healthcare Community Plan, which is also a medicaid plan. I was so dead set on having VSG surgery, but found out MOST medicaid hmo's like ours ONLY pay for gastric bypass since the VSG is a newer procedure. I would call your plan to see if they cover VSG and what the requirements are. I would check out Dr. Barkan or Dr. Brathwaite at Winthrop Hospital bariatrics. They are amazing and MAY operate on you despite your age.

  • Author

I guess i'll have to call them. I mean honestly i don't want any malabsorption surgeries like bypass . I'll probably be fine NOW, but then I think about when i'm in my granny days and those synthetic vitamins aren't doing what they used to and i think i'd be healthier if i stayed obese.

What are your stats by the way? BMI? Maybe they can look past the whole age thing if they see that it's medically necessary right now.

  • Author

right now my bmis 44.5, i have back pain, joint pain. asthma, S.A.D, shortness of breath, . my cholesterol and bp is pretty much normal though

  • 11 months later...

I didn't realize we live basically pretty close to one another. I live in Mineola on Long Island. I have similar insurance to yours....United Healthcare Community Plan, which is also a medicaid plan. I was so dead set on having VSG surgery, but found out MOST medicaid ***'s like ours ONLY pay for gastric bypass since the VSG is a newer procedure. I would call your plan to see if they cover VSG and what the requirements are. I would check out Dr. Barkan or Dr. Brathwaite at Winthrop Hospital bariatrics. They are amazing and MAY operate on you despite your age.

I am having surgery with Dr Barkan. DId you use him? any complications?

  • 3 months later...

Having sleeve done on Dec 4 with Dr Brathwaite. I have United Healthcare Community Plan.

Had to jump through hoops with the insurance company. Had to see my primary Dr 6 months in a row.

Im excited and nervous at the same time. When i met Dr Brathwaite in May i was 325 at 5'10". Bmi was like 46. Now im 295.

Im dreading the 2 week liquid diet prior to surgery. But ill get through it. Any advice on what i should be drinking during that time?

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