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will Medical cover the sleeve?



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Hello I am wanting to know if I am wasting my time and hoping for nothing....Do any of you know if Medi-cal will approve the sleeve procedure? Does medi-cal even cover any wls?? thank you for your help.....

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thank you for your help :) I am going to be getting the Obama care but the low income Medi-cal and I didn't know if the low income medi-cal insurance covers wls.... I unfortunately cannot afford to finance the wls on my own...If anyone who has medi-cal and has had wls covered, please give me a little insight on approval or what wls was covered I would really appreciate it!! thanks :)

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I have Medi cal and my sleeve was covered. I started the process last Jan and was sleeved in June. It wasn't a battle at all.

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That is soo great to hear!! Do you remember what criteria you had to have? like BMI or anything else? I am really considering wls but I have many questions and I am also worried about possible complications later in life?

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I had a bmi of 41 but no comorbidities. I'm not sure what their requirement was. It was a very easy process and I had no out of pocket. I'm very grateful because this surgery changed my life and I never would've been able to afford it on my own.

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Thank you so much for talking with me, I really appreciate it. I think my BMI is something like almost 46 :/ yikes! I still can't believe I let myself gain this much after losing 75 pounds a few years ago, all I was doing was diet and exercise but unfortunately I gained it all back...I want a tool to keep the weight off for good and I feel like the sleeve looks like the best option for me. Congrats to you on making this big decision! If it's ok for me to ask...how much have you lost since your surgery? is it hard to keep on track?? Also how was the recovery and the recovery time? thanks again for the advice and help!

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What state do you live in? Individual states determine if they cover wls or not. I would suggest you call the 800 number and ask them directly what benefits your plan covers. I don't have medi-cal, but I am a medi-cal provider. Many states, such as New York and California now require insurance companies to cover WLS but other states like Minnesota and Connecticut do not. Good luck!

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I am still in the process of getting Medi-cal but as soon as I get my card I will definitely call :) thank you! I do live in CA so I am getting a little more excited now with this new hope! It is still a huge decision for me to make so wish me luck and thank you all for your wonderful help!!

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I started at 280 and now weigh 191. I'm also in CA. Best of luck to you! I don't know if this makes a difference but the provider of Medi cal I have is Cal Optima.

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I have Medicare and Medi-Cal. Medicare will be covering 80% of my surgery and Medi-Cal will be covering the remaining 20%. I hope you're covered. Keep us updated. :)

Edited by chad.vicious

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I started at 280 and now weigh 191. I'm also in CA. Best of luck to you! I don't know if this makes a difference but the provider of Medi cal I have is Cal Optima.

hi there I am new to this site I just got cal optima and read that you had it too.ca you help me? How was the process for you? Who was your dr and what is the process? Thank you in advance and would really appreciate your help.

Chris

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • 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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.
      · 1 reply
      1. summerseeker

        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.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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