For some people, weight loss surgery is the only way to address an out-of-control obesity problem. Many people have tried and failed at alternative weight loss and management methods. Weight loss surgery may be the only way to achieve a healthy weight and way of life. These procedures can be expensive, and many patients may be unable to afford them. The cost of bariatric surgery varies depending on the type of operation, the patient, and the surgery’s location. The operation might set you back anything from $17,000 to $30,000. We will tell you How long it takes Medicaid to approve weight loss surgery.
In most circumstances, Medicaid will cover weight loss surgery if the patient meets the eligibility requirements. Each state’s coverage varies, so check with them to see what they offer. Although bariatric surgery is not officially mentioned in the Medicaid coverage rules, it is normally handled on a case-by-case basis. For the operations to be covered, the patient must meet certain conditions. Working with your doctor is required to be authorized for Medicaid coverage of your weight loss surgery.
There might be many questions running through your mind, such as whether it is hard to get approved for weight loss surgery. or
How long is the waitlist for weight loss surgery?
Scroll down to know more!
How to get weight loss surgery approved?
You must meet the conditions below for Medicaid to reimburse the cost of your operation and associated surgeon visits.
- A female must be over the age of 13, and a guy must be over the age of 15.
- A BMI of 35 or more is required, as well as the presence of at least one comorbidity.
- Sleep apnea, high blood pressure, high cholesterol, and diabetes are examples of co-morbidities.
- If you are under 21, you must have a BMI above 40 and at least one comorbidity.
- According to a letter from your primary care physician, weight loss surgery is medically required.
- Completes a psychological examination.
- Documentation demonstrating that the patient attempted but failed to manage their comorbidities with normal treatment
- The patient must fill out and present confirmation that he or she completed a 6-month medically supervised weight loss program within the previous 12 months before surgery.
- The patient must recognize that they must adjust their diet and lifestyle after surgery.
- Before and after surgery, nutritional and psychological therapies must be accessible.
If any of the following apply to you, you may not be eligible for weight loss surgery coverage:
- Steroid usage over a long time
- Malignant cancer
- Inflammatory bowel illness, chronic pancreatitis, pregnancy, or non-adherence to medical therapy are all possible causes.
- Psychological treatments that may interfere with post-operative diet and lifestyle compliance
What Weight Loss Procedures are Covered by Medicaid?
When does coverage kick in?
In most circumstances, Medicaid will cover gastric bypass, gastric sleeve surgery, and lap-band surgery. These surgeries are among the most common, and Medicaid is more willing to recognize them as medically necessary to a patient’s life in certain circumstances.
Gastric bypass
Gastric bypass is a treatment that sends meals straight to the lower intestine by bypassing a section of your gut. This surgery also reduces the size of the stomach, allowing for a reduction in the amount of food consumed. Because a component of the digestion process is bypassed, the body absorbs fewer calories and nutrients. Weight loss will occur as a result of the reduced food intake.
Lap-Band surgery
Lap-band surgery involves wrapping a silicone band around the top of the stomach and filling it with balloons. This reduces the space available for entrance storage and narrows the entrance to the stomach. In comparison to other procedures, the procedure is performed laparoscopically and is minimally invasive. The band can be adjusted, and the procedure can be reversed.
Gastric Sleeve Surgery
The method of constructing a smaller stomach in the shape of a sleeve is known as gastric sleeve surgery. This allows the food to sit in a smaller space while directing it downward through the intestines. This technique limits the food consumed and is not usually considered reversible.
Do I have to wait 6 months for a gastric sleeve?
According to the findings, the average duration between the initial surgical consultation and the actual treatment was about 7 months, ranging from 7 days to 5 years. Due to insurance requirements for preoperative weight loss, about two-thirds of patients had to wait 6 months for surgery.
How long does it take for medical to approve weight loss surgery?
The answer to the question of how long it takes Medicaid to approve weight loss surgery is that from the first visit to the doctor through medical clearance; it takes around 3 months to get approved for weight loss surgery.
Conclusion
It’s difficult to know what, if any, of your surgery will be paid by Medicaid in your area. Check with your local Medicaid office to determine if this information is available. If you are required to utilize an approved surgeon, make sure you have a list of these surgeons. Each office should happily give you any required information to obtain these answers.
In other words, if weight loss surgery is necessary for improving your health or preventing a disaster, Medicaid in your area may be willing to cover the costs.
