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Fl Medicaid coverage?

CocoJenL

By CocoJenL, in Insurance & Financing

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CocoJenL    1

CocoJenL
Posted

I am looking to have the sleeve, and was told by my insurance ho (south florida community care network) that wls IS covered. Anyone else had the sleeve in south fl, with medicaid coverage? If so, what were the requirements, aand hiw long did it take for u to be approved. Any info is greatly appreciated!

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kll724    3,055

kll724
Posted

I am not familiar, but do live in Florida. There is a link from Alex under Insurance and financing forum, "Does Obamacare pay for WLS" maybe there is information there. Best wishes, Karen..aka.kll724

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CocoJenL    1

CocoJenL
Posted

Thank you! I will definitely check that out

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CocoJenL    1

CocoJenL
Posted

So. I don't think that post actually pertains to my situation as I dont have obamacare, I just have tge standard state of Florida medicaid with an h mo I've had for about 2 yrs. After speaking with a rep from the hmo, she assured me that the surgery is covered but wouldn't provide much other info about the specifics :(

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2cute2bbig    38

2cute2bbig
Posted (edited)

So. I don't think that post actually pertains to my situation as I dont have obamacare, I just have tge standard state of Florida medicaid with an h mo I've had for about 2 yrs. After speaking with a rep from the ***, she assured me that the surgery is covered but wouldn't provide much other info about the specifics :(

Hi i have medicaid in florida to and i have Staywell and it is covered. Just go to the website of the hmo that u have and it will tell u the requirements. Im sure u will have to do the 6 months supervised weightloss with your primary care doctor, a psychiatric eval and whatever other clearances that may be required by surgeon and go to a dietician and complete classes. Your bmi has to be at least 40 or above with no co-morbid conditions and 35 with at least one or two co-morbidities.

Edited by 2cute2bbig

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CocoJenL    1

CocoJenL
Posted

I've spoken with a rep from my hmo and she confirmed that it is covered. Got my referral from my pcp yesterday. The rep also stated that I may have to do 3 month or 6 month classes. I have scheduled an appt for the 9th to attend the information seminar with the center of excellence that i choose but now what do I do? This rep hasn't provided me with much info.

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CocoJenL    1

CocoJenL
Posted

My BMI is 41.7 and I also have uncontrolled HBP which I take a tier 3 med for

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2cute2bbig    38

2cute2bbig
Posted

My BMI is 41.7 and I also have uncontrolled HBP which I take a tier 3 med for

Well your bmi is over 40 and thats enough by itself with any comorbidities and you have Hbp so u shouldnt have any problems

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CocoJenL    1

CocoJenL
Posted

Hello there. I actually had sleeve surgery 4/29/15. So I'm just past 1 yr. Currently I am down 68 lbs. I must admit it was well worth the journey. I still have about 50 more lbs I want to lose. But I'm absolutely loving my sleeve!!!! And the best part... it was covered by my insurance 100%

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Nani_Mae    4

Nani_Mae
Posted

@cocjenl was it hard for the approval can you tell me more on you insurance experiance

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@@CocoJenL ^^

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@@CocoJenL ^^

Sent from my iPhone using the BariatricPal App

@@CocoJenL ^^

Sent from my iPhone using the BariatricPal App

@@CocoJenL ^^

Sent from my iPhone using the BariatricPal App

@@CocoJenL ^^

Sent from my iPhone using the BariatricPal App

@@CocoJenL ^^

Sent from my iPhone using the BariatricPal App

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

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        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

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