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Approved! Washington State Apple Health (Molina Medicaid)

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I was approved today to begin Stage 2 of Molina's bariatric program. I am a 5'5", 309 pound 35 year old female. My BMI is 50. I have one co-morbidity of high blood pressure, and a doctor who believes that WLS is medically necessary.

I also have fibromyalgia, but I do not believe they take that into consideration when it comes to medicaid.

My doctor referred me to the required orientation for Dec. 16th, 2015. I was approved today, January 11th, 2016.

I have to complete these requirements by July 4th, 2016

12 dietician visits

12 physical therapy visits

bariatric psych eval ( or my last years records from my counselor)

EKG

I live in Clarkston, WA. My PCP Tamara Bruns (Nurse) got me into the program. I will be having surgery at Rockwood Surgical Group in Spokane, WA.

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Yay I have Molina wa as well, this month I will be done with 6 months of visits. My surgeon also had me do a endoscopy, upper GI, and a sleep study as well. I'm getting excited to finish up. After the 18th I will make my appointment with surgeon again to hopefully make the date!

  • Author

I found out something interesting. Molina isnt allowed to tell you that its just completing the 12 visits of each *within* 6 months....not having to wait the six months while completing it.

My doctor says I can be fast tracked to surgery if I have all surgeon tests done, and complete 6 visits of each (nut/PT/counselor). I could have surgery done in 3 months if all things fall into place.

Edited by Bethany Copley

I had to do 12 visits with each over 6 months hmmm

  • Author

Yeah. Its an awesome loophole that my surgical office found.

  • 3 months later...
  • Author

My doctor sent in the papers to medicaid in November 2015, then i went to my required information meeting in December 2015. I got an answer back on January 9th, 2016. So approximately 2 to 2.5 months.

Edited by Bethany Copley

  • 2 weeks later...

My doctor just sent in the stage 1 paperwork to start the process with Molina, I am 325 and 5'5 with sleep apnea and osteoarthritis, I'm hoping to get an approval to start stage 2 in a few weeks

Sent from my iPhone using the BariatricPal App

What insurance do you have? I have been waiting for almost 2 months and still no approval.

My doctor just sent in the stage 1 paperwork to start the process with Molina, I am 325 and 5'5 with sleep apnea and osteoarthritis, I'm hoping to get an approval to start stage 2 in a few weeks


Sent from my iPhone using the BariatricPal App


Oh I see.. it's Molina.. same as mine.

What insurance do you have? I have been waiting for almost 2 months and still no approval.

My doctor just sent in the stage 1 paperwork to start the process with Molina, I am 325 and 5'5 with sleep apnea and osteoarthritis, I'm hoping to get an approval to start stage 2 in a few weeks


Sent from my iPhone using the BariatricPal App

What insurance do you have? I have been waiting for almost 2 months and still no approval.

My doctor just sent in the stage 1 paperwork to start the process with Molina, I am 325 and 5'5 with sleep apnea and osteoarthritis, I'm hoping to get an approval to start stage 2 in a few weeks

Sent from my iPhone using the BariatricPal App

>

Im on the same insurance.. its been almost 2 months and still no word. One lady told me 2 months.. she was on Molina too.

My doctor just sent in the stage 1 paperwork to start the process with Molina, I am 325 and 5'5 with sleep apnea and osteoarthritis, I'm hoping to get an approval to start stage 2 in a few weeks

Sent from my iPhone using the BariatricPal App

Apples Medicaid, when I went in for my appointment my doctor did the blood tests and had me schedule the seminar while at the appointment. His insurance biller knows how to ride the insurance companies for quick replies

Sent from my iPhone using the BariatricPal App

Oh I see


Apples Medicaid, when I went in for my appointment my doctor did the blood tests and had me schedule the seminar while at the appointment. His insurance biller knows how to ride the insurance companies for quick replies


Sent from my iPhone using the BariatricPal App

I also wrote a personal letter to Molina as to why I need the surgery, I listed all 12 diets that I have been on over the last 5 years, all my weight related issues, and my supports. The goal was to make Molina understand how motivated I am and how much I need the surgery, now we have to wait for the approval to take the next step

Sent from my iPhone using the BariatricPal App

Did you know that you cannot do anything until you get approved for stage 2? It wont count if you do.

Apples Medicaid, when I went in for my appointment my doctor did the blood tests and had me schedule the seminar while at the appointment. His insurance biller knows how to ride the insurance companies for quick replies

Sent from my iPhone using the BariatricPal App

I did the same thing under my Drs advice. I had 5 dr supervised diets.. atkins 2 times.. hgc.. all in 6 years. I wrote them a 2 page letter. Let's just hope for the best. Good Luck! I know I'll get approved but it's the wait! Im on everything as soon as I get the approval! Don't DO anything until you get the approval.. it wont count! I read it in the rules!

I also wrote a personal letter to Molina as to why I need the surgery, I listed all 12 diets that I have been on over the last 5 years, all my weight related issues, and my supports. The goal was to make Molina understand how motivated I am and how much I need the surgery, now we have to wait for the approval to take the next step


Sent from my iPhone using the BariatricPal App

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