Obesity is a growing problem all over the world. For this reason, the demand for weight loss surgery is consistently increasing. The patients need financial assistance for this surgery, and it is available in the form of Medicaid. In this scenario, people often find the answer to how long does it take Medicaid to approve weight loss surgery.
Requirements for Medicaid may vary over other insurance plans. Remember, Medicaid is different in terms of covering a patient. If you need this cover, you have to meet specific requirements to qualify for the surgery. You must not have possible health issues that may be a hurdle in your surgery.
- After passing two tests, you will be able to get financial assistance for your surgery. Check the eligibility criteria to get Medicaid for your weight loss surgery.
- A female must be more than 13 years of age, and the age of the male should be over 15.
- The applicant’s BMI (Body Mass Index) should exceed 35, and you should have almost one comorbidity, including sleep apnea, high blood pressure, diabetes, and high cholesterol.
- If your age is less than 21, you must have a BMI of over 40 with almost one co-morbidity.
- A letter from primary care physician states that your weight loss surgery is necessary medically.
Pass one psychological exam.
Documentation highlighting that the patient is trying to manage his/her comorbidities with standard treatment. This treatment was unsuccessful.
- The patient should show and complete documentation that he/she participate in a weight loss program under the supervision of a doctor for six months. This process must be completed almost 12 months before surgery.
- A patient should understand that he/she has to change his/her lifestyle and diet after surgery.
- Psychological and nutritional services should be available after and before surgery from the office of the physician.
Who is not eligible for weight loss surgery?
Some people may not qualify for this surgical treatment through Medicaid. If you have any of these issues or conditions, you may not qualify.
- A long-term user of steroids
- Inflammatory bowel issue, pregnancy or chronic pancreatitis
- Malignant cancer
- Psychological treatments that can interfere with lifestyle or new diet
- Non-compliance with different medical treatments
What may weight loss procedures covered by Medicaid?
- Surgery for gastric sleeve
- Surgery for gastric bypass
- Gastric lap bands (realize band and lap band)
Essential Things to Consider for Medicaid
If you want funds for your surgery from Medicaid, you have to fulfill the requirements of this cover. Make sure to choose a center of excellence for your surgery. Medicare will visit the surgery center to assure that you can get the best treatment.
Feel free to discuss different options with Medicare about the coverage. You have to undergo several types of treatments and surgery for weight loss. For instance, weight loss surgery, lap gastric banding, and gastric bypass. In this situation, you will need insurance coverage for all the procedures.
How long does it take Medicaid to approve weight loss surgery?
Long wait times are common in the case of Medicaid. Remember, the typical wait time may vary between 86 days and 159 days. Delays are typical for patients who need Medicaid. It is a government program for health insurance for low-income people in America.
These patients are three times more than people looking for private insurance. The typical wait time may be more than 200 days. Pre-surgery requirements of Medicaid may put up needless obstacles. The program helps patients to participate in a weight-loss program under the supervision of doctors.
With these requirements, it is not possible to predict the long-term success of this treatment before surgery. Requirements of private insurers may vary, but they need proper documentation from patients.
Insurers have to prepare for pre-operative evaluations of the kidney, lungs, and heart function. This process needs visits to multiple doctors. Remember, weight loss surgery is famous as bariatric surgery. It can be executed in different methods, but involve altering your digestive tract to a particular limit.
It may change the eating habits of a person along with the absorption method of nutrients. As per the US NIH (National Institutes of Health), surgery for weight loss may be an excellent option for people over 40 BMI.
Measurement of BMI may base on the height and weight of patients. If your BMI is almost 35, you can be an ideal candidate for this surgery, even with sleep apnea and type II disease.
Cost of Weight Loss Surgery
The average cost of weight loss surgery may vary from $15,000 to $25,000. This surgery involves some risks, such as infection and bleeding. You may face some dangers of nutritional deficiencies. Remember, these patients need minerals and vitamins.
In numerous cases, advantages may be extensive. With the help of surgery, you can cure or improve several conditions, including high blood pressure and type II diabetes. Some patients can lose between 57 and 59 pounds in one year.
Outcomes of weight loss surgery may vary for every patient. Some patients may need more time to lose weight for particular health conditions. Surgery is considered a last resort, but it is an effective treatment to shed extra pounds.
Important Facts about Medicaid
Medicaid is an essential source of health care insurance. Some advantages are mandated by state or federal. Weight loss covers are available for every individual. Remember, excessive weight and obesity are the main contributing factors to different health issues.
If you have access to medical care via a Medicaid program, you can get suitable financial assistance and the best options for treatment. Several states administer these programs. Some critical aspects of these programs are undeviating by federal policies.
Each state is allowed to determine their policies for Medicaid covered programs for weight loss. In numerous cases, weight loss management becomes easy with the help of prescribed medications. Weight loss drugs are excluded from the coverage of Medicaid programs.
Inconsistencies in each state may make things difficult for patients. You may get coverage for your weight loss medications as per the rules of your state. To get Medicaid cover, you have to find out how long does it take Medicaid to approve weight loss surgery.