NYS MEDICAID (Fidelis)

[Denise Camejo 6]

Hello all- today i am going to speak with my PCP doctor about weight loss surgery, in specific about VSG.

i have Fidelis/medicaid. How long was the process up until surgery when you initially spoke to your PCP about weight loss??

What requirements did Fidelis or Medicaid set in place for you to be approve?

Thanks!

[Tyra662315 4]

For me it was about 4 months. The process was criteria based, I had 3 months of scheduled appointments with the doctor/nurse and I had to have 2 visits with the nutritionist and one after surgery. I had to get a letter of medical necessity from my PCP, and psych evaluation, and I had to lose like 20lbs, and that might be different from others. I also had to take a nutrition class. There may be a few more things but I'm thinking off top right now. I'm 2 weeks post op.

[GreenTealael 24,857]

1 hour ago, Denise Camejo said:

Hello all- today i am going to speak with my PCP doctor about weight loss surgery, in specific about VSG.

i have Fidelis/medicaid. How long was the process up until surgery when you initially spoke to your PCP about weight loss??

What requirements did Fidelis or Medicaid set in place for you to be approve?

Thanks!

Hi,

I consulted with a bariatric surgeon before I even spoke to my primary about it ( you will need your primary to sign off as well so don't worry about the order, it's good to have them on board from the start, if they aren't try to convince them or switch) because I did not need a referral to consult with the bariatric program. From start to surgery just under six months. All of that time as just to complete the preop testing , there was not a required waiting period.

[djamal29 0]

On 1/9/2018 at 11:26 AM, 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

Were you able to get the surgery approved with MVP? Im just starting to find research and I am not sure where to start. Should i see a surgeon first or my pcp?