When more than 82 million Americans enrolled in Medicaid programs, many people started wondering whether Medicaid covers weight loss programs. Well, it depends on several requirements that include weight loss supplements, diets, surgery, vitamins, medicines, counseling, bariatric or obesity screenings, etc. Read this article to the end to learn what coverage you can get through Medicaid.
Medicaid's Approval Process for Weight Loss Surgery
If your state's Medicaid program covers weight loss surgery, you should get approval for it by scheduling a consultation with a doctor. During the consultation, the surgeon will go through your medical details and discuss all possibilities. After you make the decision, the surgeon will run different tests to assess your health, and if he agrees to the surgery, you can ask for pre-approval from the state Medicaid office.
The whole process needs some time and patience. If Medicaid approves the surgery, the doctor needs to confirm whether you are ready to go through it. This means blood tests, x-rays, and other surgical processes. It’s quite tough to decide which part of your surgery will get Medicaid coverage in your state. However, you can confirm with your state Medicaid office whether they can provide this information.
Does Medicaid Cover Weight Loss Programs?
In terms of weight loss surgeries, you can get coverage through Medicaid for the following procedures:
· Gastric sleeve surgery
· Lap gastric bands
· Gastric bypass surgery
However, Medicaid will cover these weight loss procedures only if you fulfill certain criteria. Let’s have a look at them:
· You must submit a letter from your primary care physician mentioning the weight loss procedure.
· You should be a woman over 13 or a man over 15.
· There should be evidence indicating that you have tried to deal with some comorbidities like high blood pressure, high cholesterol, diabetes, and sleep apnea with basic treatment but with no success.
· You should have more documents stating that you were enrolled in a medically supervised weight loss program for half a year and that it occurred one year before your surgery.
· Your BMI must be more than 40 if you are under 21 and more than 35 if you are over 21.
· You should pass a psychological analysis.
· You should give confirmation about your routine and diet changes after the weight loss surgery.
If you have the following issues or conditions, you will not qualify for weight loss surgery coverage through Medicaid:
· Malignant cancer
· Psychological therapy that could interrupt your new diet and lifestyle regimen
· Longer use of steroids
· Incompatibility with medical treatments
· Pregnancy, inflammatory bowel disease, or chronic pancreatitis
Additional Considerations for Medicaid
You should also undergo your weight-loss surgery through a Center for Excellence to get Medicaid coverage. Bariatric Center for Excellence accreditation identifies which bariatric surgery centers have achieved excellence in bariatric surgery. You must visit one of these centers to be assured of getting the best possible treatment.
If you need to learn more about Medicaid’s coverage regarding weight loss programs, feel free to contact Fidelity Healthcare.
