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NYS MEDICAID (Fidelis)



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Hi there,

I was able to have VSG through NYS funded health insurance. Anyone else have the same insurance or situation and want to share tips or stories for future patients? Or just want to ask questions? Lets do it here!

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Hello,

I am currently going through the process to have VSG surgery with NYS health insurance. I have MVP Healthcare and medicaid an I am nervous that I will be denied as I am morbidly obese with a BMI of 45 but do not have any comorbidities. I have a psychiatric evaluation coming up and I have to get a 6 month sign off from my primary doctor.Any advice or tips for me to ease my nerves

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29 minutes ago, Dezz87 said:

Hello,

I am currently going through the process to have VSG surgery with NYS health insurance. I have MVP Healthcare and medicaid an I am nervous that I will be denied as I am morbidly obese with a BMI of 45 but do not have any comorbidities. I have a psychiatric evaluation coming up and I have to get a 6 month sign off from my primary doctor.Any advice or tips for me to ease my nerves

here's what I suggest because it helped me a great deal :

Contact your insurance company to find out exactly what the requirements are and what would be cause for denial.

Also find out if the procedure is totally covered of if you will be responsible for some of the costs. (my nutrition and sleep evaluations were not covered but required so I have to take care of those)

Track all of your required preop appointments meticulously

Follow the recommendations (diet wise) as best as possible.

Be super proactive and don't wait for the doctors office to stay on top of things for you. You don't know want to waste 6 months of your time if you don't have to.

Congrats you'll do amazing!!!

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Surprisingly the surgeon who is gonna be performing my VSG is scheduling all of my pre-op appointments for me. They just said that MVP Healthcare is tough. They've been dealing with my insurance on my behalf as well so they know what doctors to send me to for pre-op.

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My Surgeons office also handled all of my appointments as well but the ladies at the front desk seemed in no rush to get me scheduled asap.for things ...

And I was in a serious rush - I wanted surgery immediately so I stayed on top of things to speed it up. I didn't have a 6 month waiting period with Fidelis. So for me start to finish was just shy of 6 months.

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Hello, I am also trying to get vsg though Fidelis Ny. do you mind telling me how long it took you to get approved?

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Hello, I am also trying to get vsg though Fidelis Ny. do you mind telling me how long it took you to get approved?


Hi there,
Any news?

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5 hours ago, Tyra662315 said:

Did anyone have to lose 5% of their body weight as an insurance requirement with Fidelis?

I don't remember that being a requirement of insurance but definitely a requirement of my surgeon.

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Ok, I figured as much. I'm worried because I have stuff planned in a few months so I'm on a tight timeline and losing 20lbs is like the last thing left for me to do. Thanks for responding too!

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Ok, I figured as much. I'm worried because I have stuff planned in a few months so I'm on a tight timeline and losing 20lbs is like the last thing left for me to do. Thanks for responding too!

I suggest developing your new habits now. If you leave it all until right before surgery it becomes a stressor and the transition is not as smooth.


HW 270
SW 238
CW 188
VSG 11/7
[emoji471][emoji471][emoji471]

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