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Medicaid and Mini GB..



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I'm in Oregon, it only covers RNY and sleeve.

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In California it covers RNY and VSG without issue as long as you do the 6 month monitored weight loss. It's difficult to get it to cover the DS, and Loop DS (but my Loop DS got approved). I haven't heard anything about MGB though so I don't know if it's covered here. Personally, I think it'd probably be like the DS and Loop DS and be a pain in the rear end to get them to approve it, but I'm sure some people have gotten lucky.

Edited by NovaLuna
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2 hours ago, NYCGirl9269 said:

Does anyone know if medicaid covers mini gastric bypass??

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I'm not American, nor knowledgable your insurance system, but did a ton of research prior to my mini gastric bypass: it basically said American doctors - most of whom making a living doing RNY and sleeve - consider it "experimental". I mean, 20 years of studies and stuff, with fewer average complications, shorter surgery time and higher average EWL, but apparently not good enough :D

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Most likely not, as the MGB has never been accepted by the ASMBS and few, if any, US insurance policies cover it as it usually still falls under the "Experimental/Investigational" label. The only ones routinely covered in the US (with Medicare as the primary guideline) are the RNY, DS, VSG and lapbands. For a long time the DS was classed as experimental, but once Medicare accepted it, the private insurance companies could no longer use that dodge to avoid coverage.

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Thanks for all your info people! Talked to my surgeon today who was one of the first who started the loop DS or SIPS and he recommended that procedure for best insulin stability long term and weight loss.. and he just uses the same procedure code as for regular DS so it's no problem. Anyone in NYC also had modified DS or SIPS/SADI-S done by him.?

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