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Anyone Get a Lapband Approval with Medicaid?

Im just wondering if Anyone here gotten an approval for Lapband with Medicaid, and if so in what State.

I'm in Georgia, and I'm wondering what I'm up against. I know it can be approved.

Thanks!

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Im just wondering if Anyone here gotten an approval for Lapband with Medicaid, and if so in what State.

I'm in Georgia, and I'm wondering what I'm up against. I know it can be approved.

Thanks!

I personally do not have medicaid insurance however, the person that referred me to my surgeon does. They actually had an easier time getting approved then my private insurance Coventry. She was on the low side of BMI and had 1 co-morbidity and all total took her 3 months from initial appt to surgery. Good luck and just hangon, insurance can be tough but worth the wait!!! Im in DE

Edited by steelergirl
Forget state

  • Author
I personally do not have medicaid insurance however, the person that referred me to my surgeon does. They actually had an easier time getting approved then my private insurance Coventry. She was on the low side of BMI and had 1 co-morbidity and all total took her 3 months from initial appt to surgery. Good luck and just hangon, insurance can be tough but worth the wait!!! Im in DE

Thank you for answering, I am hoping to hear something from them today, actually. Just the ball rolling but It would make me happy to know I could start looking for my Surgeon. How has your progress been?

I'm in WI and it's a no-go with Medicade unless you have MAJOR weight related health issues. And then it's a bypass only, no banding for anyone with a BMI higher than 45. I'm doing self-pay because even if we fight it and win I don't want the bypass. Apparantly WI just tightened down last March, prior to that it was easy to get approval.

Thank you for answering, I am hoping to hear something from them today, actually. Just the ball rolling but It would make me happy to know I could start looking for my Surgeon. How has your progress been?

I had to complete a documented 6 month diet with nutritionist. I started the process in late April and had my last appt with doctor on October 21st. I was approved on the 24th and scheduled for surgery on Nov 12th!

The first 3 months ...my head wasn't in it. I had lost and gained so much weight throu my life I just wanted to not think about it. I actually gained about 15 lbs from April to Sept.

Then I just realized one day that I had to be invested. I had waited all this time and "What if they still denied me?" I still wanted to lose the weight and get healthy. So I woke up that next day and BAM! I've been on track ever since. I have lost 36lbs since middle of September and feel great. The pre-op has been easy for me and I also started walking 30 minutes a day and light areobics 30 minutes about 5X a week.

The insurance i think was just doing what their policy said. and I would imagine that there are some that give up when they hear they have to wait 6 months. Not me....I'm stubborn!! Keep me informed about your progress, stay on top of it!

  • Author
I'm in WI and it's a no-go with Medicade unless you have MAJOR weight related health issues. And then it's a bypass only, no banding for anyone with a BMI higher than 45. I'm doing self-pay because even if we fight it and win I don't want the bypass. Apparantly WI just tightened down last March, prior to that it was easy to get approval.

It's pretty much the same here. Its a requirement you comorbordoties, (which I do.) But if they tell me they want to do a Gastric Bypass I'm going to have to say no. They are not going to cut up my stomach. I'm not taking that risk. I have known 3 people personally to have died from complications from Gastric Bypass. Not worth it to me.

I have a Surgeon Consult appointment next week, and I spoke with Medicaid they do approve Lapbands the paperwork just has to be submitted. So I know its a possibility. I'm just trying to see what I'm up against.

Good luck on your joureny ahead. Let me know how things are going!

  • Author

Congratulations on your upcoming Lapband date! Just one more day! Are you nervous? I think I would be!

I know what you mean about getting invested! I've been doing real well on my Preband eating plan but the last two days Ive been slipping a lot. I need to get invested in what I'm about to do. I have everyone in my house Synced up to get healthy, and they aren't getting Lapbands. Just me. They are just going to start eating healthy with me, and doing exercise. If I crap out so will they. I've got to get invested NOW! I really do want to get Healthy! Just with my Lapband Consult Appt. so far off, all of it feels a long time away. Ive got to get on Top of this! LOL, I think I need sleep. I will praying your Surgery goes well! Keep in touch!

I had to complete a documented 6 month diet with nutritionist. I started the process in late April and had my last appt with doctor on October 21st. I was approved on the 24th and scheduled for surgery on Nov 12th!

The first 3 months ...my head wasn't in it. I had lost and gained so much weight throu my life I just wanted to not think about it. I actually gained about 15 lbs from April to Sept.

Then I just realized one day that I had to be invested. I had waited all this time and "What if they still denied me?" I still wanted to lose the weight and get healthy. So I woke up that next day and BAM! I've been on track ever since. I have lost 36lbs since middle of September and feel great. The pre-op has been easy for me and I also started walking 30 minutes a day and light areobics 30 minutes about 5X a week.

The insurance i think was just doing what their policy said. and I would imagine that there are some that give up when they hear they have to wait 6 months. Not me....I'm stubborn!! Keep me informed about your progress, stay on top of it!

I completely understand what you mean! I think the difference for me is that I was so STRICT in the past that if I "messed-up" by eating anything that was unhealthy, I just threw it all away. This past weekend, with permission from my nutritionist, I had a half cheesesteak (no mayo, lite cheese and the bread gutted) and a piece of my birthday cake. It was my birthday and I was not going to jeopardize the surgery or outcome. I had that meal and 4 cocktails.....with no weight gain all weekend. I was so excited. I think I have actually learned to eat in moderation and for the first time in my 40yrs.....listen to my "full" button. Please let me know as you go through your appt how things go for you...how much do you have to lose?

  • Author

I think that is so awesome that you've learned to eat in moderation! You are conquering your food demons. Woooo hoooo! I hope you did a Happy Dance because you Rock, Girl!

I have somewhere between 180- 200lbs to lose depending on loose skin. I am being realistic that I have been heavy skin my teen years, and have stretched my stomach out since I was 14 or 15. Keeping that in mind, when I get down to a healthy weight I may still have several lbs of loose skin left around my middle. My insurance(Medicaid) doesn't cover this surgery ever. It has been suggested to me to start thinking about how I could raise the money for PS. I am not concerned with what I will look like I just want to get healthy. But I do realize the extra skin may have me weighing in higher on the scale than I original was thinking for a goal weight. I will be praying for you in the AM! Come in and let me know how things went for you!

I completely understand what you mean! I think the difference for me is that I was so STRICT in the past that if I "messed-up" by eating anything that was unhealthy, I just threw it all away. This past weekend, with permission from my nutritionist, I had a half cheesesteak (no mayo, lite cheese and the bread gutted) and a piece of my birthday cake. It was my birthday and I was not going to jeopardize the surgery or outcome. I had that meal and 4 cocktails.....with no weight gain all weekend. I was so excited. I think I have actually learned to eat in moderation and for the first time in my 40yrs.....listen to my "full" button. Please let me know as you go through your appt how things go for you...how much do you have to lose?

yes i have hip medicaid and my surgeon says they are excellent and he has never had a problem with them

in fact they will approve within a week !

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