So, I am covered under Medicaid in Indiana. But honestly I understand absolutely nothing about my insurance. Apparently my medicaid is called the Healthy Indiana Plan plus but under that you have to choose a health plan and mine is Managed Health Services. I'm at a loss of what I'm doing to try to confirm my requirements for Surgery. I've called my surgeon's office and gotten mixed answers about what's required. One lady gave me info for MHS requirements and either the same or different lady said I need to meed medicaid requirements when I called back a couple weeks later. I'm actually confusing myself more as I write this, but is there anyone from Indiana who knows what I'm talking about. Or anyone in general that can help me ask the right questions to get the right answers? I just want to make sure I'm going in the right direction! Thanks in advance for any suggestions!

I have the same plan and having the same problems I called mhs and they refused to give me the requirements.

That's so weird! I don't know if its comforting or distressing that you had the same issue. I just spoke to the "insurance specialist" at IU Health, She informed me as of Thursday that I'm to follow HIP's requirements and NOT MHS! Thank goodness if that's really correct because there's a lot less involved. Message me if you wanna talk privately tripeletmommy2+

I would love to chat with you. I'm very discouraged I will try to message you. I'm not sure how to do it through this app.

i have medicaid through md and also have a managed health service but they are my secondary and they dont really have requirements just that my primary cover the surgery so im at a loss as well

There is a document that they don't want us to have. It's crazy, but it does exist.

I am in the process of getting HIP with MHS. Do you have HIP Basic or HIP Plus? Bariatric surgery is ONLY covered under HIP Plus. I was told they recommend (but don't require) 6 months supervised diet, BMI of 40, or BMI of 35 with 1-comorbidity, nutritionist evaluation and psychological evaluation.

I have hipp plus! The centers around here require 6 mo.which is a problem since I'm up for review in spring and I may get kicked off again. Where did you go? It might be worth the drive for me.

I have hipp plus! The centers around here require 6 mo.which is a problem since I'm up for review in spring and I may get kicked off again. Where did you go? It might be worth the drive for me.

Floyd Memorial Weight Management and Bariatrics in New Albany

I am also with HIP 2.0 - but I have anthem- anthem requires 7 months of classes/diet -- would love to connect with local people- anyone else with community north? I don't understand the first thing about insurance ????

I guess that should of said hip plus --

Hello...I'm new here, just found this forum while I was searching for information about HIP and Bariatric surgery. I have MDWise, and I also can't get them to tell me anything about the requirements other than it requires Prior Authorization. I've gone to the required Bariatric seminar through IU health north and am waiting on the call for the surgeon consultation. I'm just a nervous wreck not knowing if I'll be approved and if I'm wasting time that I don't have to waste. I just wanted someone to tell me what the criteria is for the surgery so I don't have to make all these 2 hour drives to IU health north for appointments just to be told I never had a chance! Very frustrating! So if anyone has any info or advice I'd love to hear it!

Update: Found out from the insurance co-ordinator at my surgeon's office that for HIP Plus through MHS they require 6 months of medically supervised weight loss along with a daily food and exercise log for the entire time. You must show at least 80% compliance on the logs (with daily exercise, etc.). Also, once they have the 6 months and submit they make you keep doing the food and exercise diary all the way until day of surgery. In addition they require (aside from the psych visit) a cardiologist appointment, ekg, echo on the heart, pulmonologist (sp?) visit, and sleep study. They said that HIP Plus (through all providers) is the HARDEST insurance they have to get approval on. Much different than what MHS told me when I initially contacted them.

Hmm...I wonder if that is the reason that they haven't called to schedule my consultation yet because they don't want the hassle!

Update: Found out from the insurance co-ordinator at my surgeon's office that for HIP Plus through MHS they require 6 months of medically supervised weight loss along with a daily food and exercise log for the entire time. You must show at least 80% compliance on the logs (with daily exercise, etc.). Also, once they have the 6 months and submit they make you keep doing the food and exercise diary all the way until day of surgery. In addition they require (aside from the psych visit) a cardiologist appointment, ekg, echo on the heart, pulmonologist (sp?) visit, and sleep study. They said that HIP Plus (through all providers) is the HARDEST insurance they have to get approval on. Much different than what MHS told me when I initially contacted them.

I was denied today bc they asked after my 1st approval for the food and exercise logs but they wouldn't say how many they wanted. So we turned in 3 months worth. They also denied bc I had a low PFT, bc I was sick. So peer to peer is going to happen now. I'm 10 months in, and still fighting MHS

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@@BonnieGail Sorry to hear this. I was told I have to have the entire time of food and exercise logs, so that's December 1 through May 31 for me. They told me to keep doing them because they can ask for them at any time to prove you're still compliant. My final nut. visit is May 31 and we are submitting to insurance on 6/1. All of my other tests were great except I'm on a CPAP now, but I'm compliant with that as well..... it's such a process!

@@BonnieGail Sorry to hear this. I was told I have to have the entire time of food and exercise logs, so that's December 1 through May 31 for me. They told me to keep doing them because they can ask for them at any time to prove you're still compliant. My final nut. visit is May 31 and we are submitting to insurance on 6/1. All of my other tests were great except I'm on a CPAP now, but I'm compliant with that as well..... it's such a process!

Yes I started last aug, and I've submitted 3 times. It's like pulling teeth with mhs to know exactly what they want. Everytime they've come back with more and more tests. And I submitted the logs 2 months ago, and they're just saying not enough. It's aggravating!!

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