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Does Medicaid Cover Weight Loss Surgery?

Does Medicaid Cover Weight Loss Surgery?

Table of Contents

Does Medicaid Cover Weight Loss Surgery?



The decision to pursue weight loss surgery is an important one and the fact that it can be expensive is a major factor in the process. One potential source of financial help you might be wondering about is Medicaid.

Does Medicaid cover weight loss surgery? Unfortunately, in most cases, the answer is no. Depending on the state you reside in, Medicaid might cover bariatric surgery as medically necessary, but this is rare. Most states only provide coverage when a person meets certain BMI criteria (normally 40 or more) and has a weight-related condition like type 2 diabetes or sleep apnea.

Alternative Weight Loss Solutions



Since Medicaid does not normally cover weight loss surgery, that does not mean you have to give up on the idea of achieving your weight loss goals.

One option is MYFITAPE, a health platform that offers tailored weight loss sessions through interactive video appointments. It is ideal for those who wish to reach their weight loss goals in a safe, healthy and sustainable manner.

Booking Through MYFITAPE Platform



To start the journey towards a healthier version of you with MYFITAPE, you will need to create an account and book an initial 30-minute video appointment with a qualified health professional. During this meeting, your current health, lifestyle and goals will be discussed in order to design the perfect plan to suit your specific needs.

Subsequently, booking following sessions can be done with the simple click of a button and payments can be made securely through the platform.

Weight Loss FAQ



What does MYFITAPE offer?

  • MYFITAPE offers customized online diet and fitness plans through one-on-one interactive video appointments with qualified health coaches.



Does MYFITAPE offer multiple appointment options?

  • Yes. You can choose from various appointment lengths and session frequencies.



How long does it take to see results?

  • That will depend on your individual circumstances. Generally, it can take a few weeks or months to start seeing measurable results, depending on how closely you follow the program and make any lifestyle changes recommended by your health coach.



Is there a cost involved?

  • Yes. MYFITAPE charges a fee for the one-on-one consultations and related services. However, you can use the platform for a 7-day free trial.



Conclusion



While Medicaid does not normally cover weight loss surgery, that does not mean giving up on your weight loss goals and dreams. MYFITAPE can help you get healthier, stronger and more confident with an affordable and customizable plan based on your individual needs. To start your journey, simply create an account and book an initial 30-minute video appointment with one of the qualified health professionals on the platform.

What does Medicaid consider to be an acceptable medical reason for weight loss surgery?

Medicaid generally considers individuals for weight loss surgery if they meet certain criteria, such as having a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with comorbidities (conditions such as type 2 diabetes, high blood pressure, or sleep apnea) that are improved by weight loss. Other conditions may be taken into consideration on a case-by-case basis.

Does Medicaid require any type of prior authorization for weight loss surgery?

Yes, Medicaid does require prior authorization for weight loss surgery. Generally, this process entails obtaining a referral from a primary care provider, obtaining pre-approval from the state Medicaid agency, and then submitting a completed prior authorization request to the insurance carrier. The request must include information about the patient’s medical history, a weight loss plan, and a proposal that surgery is medically necessary. Each state may have different requirements for obtaining approval.

How can a person qualify for Medicaid coverage of weight loss surgery?

In order to qualify for Medicaid coverage of weight loss surgery, a person must meet certain criteria set by the Department of Health and Human Services. Generally, the criteria involve a combination of medical, financial, and psychosocial factors. The specific criteria will vary from state to state. Generally, an individual must have a body mass index (BMI) of at least 40 or a BMI of at least 35 with one or more obesity-related comorbidities, such as type 2 diabetes, heart disease, or hypertension. An individual must have documentation of unsuccessful attempts to lose weight using non-surgical weight-loss methods, such as diet and exercise. Additionally, the individual must meet the financial eligibility requirements of their Medicaid plan.

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