Louisiana Medicaid Weight Loss Surgery - MedicAidTalk.net (2023)

Does Medicaid Cover Weight Loss Surgery?

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Medicaid Covers Weight Loss Surgery | crystals of life

Weight-loss surgery is covered by Medicaid If your insurance coverage allows weight-loss surgery, it will only be covered if you meet the following criteria: Have a qualifying body mass index of 35 or greater with a related health condition such as obesity, or have a qualifying BMI of 40 or above with no health problems related to obesity.

Bariatric Surgery Costs

The cost of weight loss surgery varies drastically depending on the type of surgery you choose, whether your insurance covers it, and where the surgery is performed. The average price varies significantly by state. Doctors and hospitals charge different rates in each state. Gastric sleeve surgeries in the United States range from $9,600 to $26,000 for paying patients without insurance.

Additional Medicaid Considerations

One of the requirements for Medicaid to cover the cost of your surgery is that the weight loss surgery must be performed by acenter of excellence. The Bariatric Center for Excellence accreditation is intended to indicate which bariatric surgery centers have achieved a level of excellence in performing bariatric surgery. Medicaid requires that you visit one of these specialized centers to ensure you receive the best possible care.

Related:How to Appeal Denial of Insurance for Weight Loss Surgery

If you have questions about your Medicaid coverage and whether or not your coverage covers weight-loss surgery, it is best to contact Medicaid staff directly to discuss your coverage. There are many types of weight loss surgeries, but Medicaid only covers the most common ones.

If you want to have any type of weight loss other than gastric bypass, abdominal banding, or gastric sleeve, you will need to look for another type of insurance coverage or pay out of pocket. for the procedure.

* Medicaid does not payWeight loss surgery in Mexico

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Resources:

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How to get approved for weight loss surgery

Our main focus is your long-term well-being. We only recommend weight loss surgery if it is a medically safe option for you. We also base our recommendations on your willingness to commit to lasting lifestyle changes. Our holistic approach gives you all the support you need to be successful. If surgery isn't the answer, we can still help you lose weight with oursweight loss medical program.

Our medically supervised weight loss program

Louisiana Medicaid Weight Loss Surgery - MedicAidTalk.net (1)

The Ochsner Lafayette General Medical Center bariatric surgery program also offers a comprehensive program for people who want to lose weight but surgery is neither a desire nor an option. The medically supervised weight loss program is an ideal avenue for patients who may be over the weight limit for surgery, don't have insurance to cover the cost of surgery, or are simply interested in losing just 20 to 30 pounds. . Running since November 2012, the program helps people make realistic dietary changes under the constant guidance of a doctor, nutritionist and lifestyle advisor.

Benjamin Doga, MD, oversees the program at Acadiana Weight Loss Surgery, based inOchsner Lafayette General Surgical HospitalA campus of the Ochsner Lafayette General Medical Center. Scheduled visits are every Tuesday and include sessions with a nutritionist. The goal is to help people lose and maintain weight safely by learning new eating habits and habits. It is essentially a lifestyle modification program that charts the best course for each individual.

Participants can choose a three- or six-month plan. dr Doga will assess patients to determine their best options, which may include personalized nutrition and/or pharmaceutical appetite suppressant support, and participants will receive ongoing professional support throughout the program.

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Developed by bariatric specialists

Our obesity surgery department is accredited as a comprehensive center for bariatric and metabolic surgeryAmerican College of SurgeonsjAmerican Society for Metabolic and Bariatric SurgeryQuality Improvement Program for Metabolic and Bariatric Surgery. We believe that surgery is a tool, not a cure, to help patients live healthy lives.

Along with surgeons Philip Gachassin, MD, Dennis Eschete, MD, and Robert Autin, MD, the bariatric support team includes a registered nurse, nutritionist, patient advocate, behavior change educator, licensed practitioner consultant, and a certified personal trainer.

Types of surgery:

  • Laparoscopically adjustable gastric band
  • laparoscopic gastric sleeve
  • laparoscopic duodenal switch

Consider the cost of weight loss surgery

Reading time: 4 minutes

TLRD

  • Being overweight is not only unpleasant, but also entails a variety of financial burdens, such as medication and health problems.
  • Bariatric surgery is an investment in your life that can help you make a change for the better.
  • Losing weight can save you money in the long run because you have lower medical costs as you age.
  • The cost of gastric sleeve surgery with Dr. Thomas Borland are $11,300. This is less than the national average of $16,800 and less than the Louisiana average of $15,400.
  • There are options to help you pay for bariatric surgeries. dr Borland does not accept insurance or Medicaid, but financing is available.

Losing weight and working healthier is an investment in the future. If you are considering bariatric surgery, you may be concerned about the cost. This is reasonable, although there are options to do it cheaper, weight loss is often expensive.

Investing in your life is often worthwhile. Many patients even save money in the long run through reduced medical costs after significant weight loss. Here is some information about the cost of weight loss surgery to help you make an informed decision.

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Stomach Tube Cost Breakdown with Dr. Borland

The cost of gastric sleeve surgery with Dr. Borland are $11,300. This is less than the national average of $16,800 and also less than the Louisiana average of $15,400. The price includes a number of services:

  • $200 fee for first office visit
  • $4,500 surgeon's fee
  • Surgeon Assistant Fee of $1,000
  • $600 anesthesia fee
  • New Iberia Surgical Center fee of $5,000

There are a few things the price doesn't cover, including:

  • Hotel stay for 2-3 days during recovery.
  • Travel to and from New Iberia, Louisiana
  • Preoperative testing if necessary

We are able to offer affordable gastric tube prices because we treat it as an outpatient procedure, allowing patients to avoid costly hospital bills. You will have to pay for your stay at a nearby hotel for a few days during the recovery period, but these costs are significantly less than hospitalization.

Medicaid weight loss surgery

Medicaid covers weight loss surgeries 2018

Medicaid generally covers weight loss surgery and related procedures. However, in addition to the three main rules of pre-certification, you must take into account a fourth consideration, which is the recommended experimental method.

  • Less Expensive: Diet and exercise programs haven't shed extra pounds, and the bariatric type of surgery isn't more expensive than alternative treatments.
  • medically necessary: Body mass index of 35 or higher combined with comorbidity: diabetes, hypertension, sleep apnea, high cholesterol
  • Regional Rules: Twenty-three states have insurance mandates for weight-loss procedures that might apply to public plans
  • Non-Experimental - The Centers for Medicare & Medicaid Services considers the specific procedure unproven and accepts no claims.

    Given the complex criteria, patients' ability to collect proper documentation determines how long it takes for Medicaid to approve weight-loss surgery. It can take weeks, months, or years, depending on how well you and your doctor present the case.

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    How much does a gastric sleeve cost in Louisiana?

    The gastric sleeve surgery by Dr. Thomas Borlands costs $11,300, which is a reasonable price. This is less than the national average of $16,800 and less than the Louisiana average of $15,400, both of which are below the national average. There are a variety of financing solutions to help you pay for bariatric surgery.

    Does Medicaid pay for the gastric sleeves in Louisiana?

    Bariatric surgery is a type of surgery that helps people lose weight. Louisiana Only until a full and prolonged diet and exercise program, with or without pharmaceutical treatments, proves ineffective over time will Medicaid fund weight loss or bariatric surgery as an option.

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    Revision surgery for weight loss

    Over the years and for various reasons, some patients may experience weight gain after the initial weight loss procedure. Louisiana Surgical Specialists are experts in weight loss revision surgeries that can be performed laparoscopically or endoscopically. If you have experienced inadequate weight loss, inadequate resolution of comorbidities, or medical complications from weight loss surgery, you may be a candidate for minimally invasive or incisionless revision surgery.

    Does Medicaid Cover Bariatric Surgery?

    Louisiana Medicaid Weight Loss Surgery - MedicAidTalk.net (2)

    In some cases, weight loss surgeries become essential for people. Dealing with obesity is not easy. There can also be instances where it gets out of hand. For the general well-being of a person, surgery is the only solution. To achieve a healthy weight and lifestyle, bariatric surgery may be the only answer. However, these surgeries can cost a little more than you think. Depending on the location, type of surgery, and patient, bariatric surgery costs can range from $15,000 to $30,000.

    In most cases,Medicaid covers weight loss surgery. In this case, the patient must meet the basic coverage criteria. This may vary by state and should be checked before proceeding. Bariatric surgery is not often mentioned in Medicaid coverage guidelines, but is treated differently for different cases. You should work with your doctor to discuss the Medicaid insurance approval process.

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    Is Weight Loss Surgery Right For You?

    It is important to know your weight loss options. There is no single solution but a combination of methods to treat obesity. These tools are part of a comprehensive approach to helping you achieve and maintain a healthy weight while improving your health. The right combination of tools and lifestyle changes are essential to a successful obesity treatment plan.

    Bariatric surgery causes weight loss by restricting the amount of food the stomach can hold, leading to nutrient malabsorption, or by a combination of gastric restriction and malabsorption. The most common bariatric surgical procedures are gastric bypass, gastric sleeve resection, adjustable gastric banding, and biliopancreatic diversion with duodenal switch. Each operation has its own advantages and disadvantages.

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    Medicaid coverage in Louisiana for gastric sleeves

    Members who like this post

    Does anyone have an up-to-date list of surgeons who accept Medicaid for gastric sleeves in Louisiana? I got a lot of rejection.

    hello alaina,

    I'm so sorry I can't tell you how many calls I get per day about your status with people crying. There "was" only one surgeon taking Medicaid out of the state that we knew of, Dr. dominguez As of May 1st, they no longer accept Medicaid.

    dr Johnny Perez admitted some Medicaid patients for WLS, but his main surgery wasn't weight loss. Due to the large number of WLS patients who, according to Dr. Dominguez came to see him, he is no longer accepting new WLS patients. Cheryl at the office said they are trying to get another surgeon into the office and have potential new patients calling in 3 months. Here is a link to your site.

    We wish you the best of luck and please let us know if there is anything else we can do to help.

    Greetings,

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    Am I eligible for weight loss surgery?

    YES! MEDICAID PAYS FOR WEIGHT LOSS SURGERY. HOW TO BE AUTHORIZED

    It takes a lot of courage to undergo weight loss surgery. We'll do everything we can to make sure it's the best option for you. There are a number of criteria for weight loss surgery that we consider to ensure a safe and medically appropriate procedure. Some of these bariatric surgery requirements include information about your general health, as well as your insurance coverage and mental health.

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    Surgical weight loss designed for results

    We provide pre-op training and post-op support for patients looking for healthier options. Not only do we guide you through the necessary steps to undergo bariatric surgery, we also provide you with the necessary tools that are critical to your post-surgical success many years after your surgery. Diet, exercise, behavior change counseling, and support groups are among the resources offered to ensure your success after surgery.

    Our goal is to offer a personalized program to help you lose weight and achieve your goals. There are many different types of weight loss surgery, and Ochsner Lafayette General has the most comprehensive options on the market.

    As the leading and most trusted Weight Loss/General Surgeon on the Gulf Coast, we are here for you with the Covid

    dr Donald Balder is a surgeon with more than 20 years of practice. He founded the Mississippi Institute for Weight Loss Surgery in September 2016 with two campuses in Mississippi and one in Louisiana: Gulfport, Hattiesburg, and Slidell.

    After completing his undergraduate studies at the University of Illinois, Dr. Balder continued his studies there and earned his medical degree before completing his residency in surgery at Brown University in Providence, Rhode Island. He is board certified in general surgery and licensed in Louisiana, Mississippi and South Carolina.

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    During his time in the Carolinas, Dr. Balder pioneered the weight loss field and established several minimally invasive weight loss and surgical programs at the McLeod Regional Medical Center and Hospital System of the Carolinas from 1997 to 2004. He performed the first laparoscopic gastric bypass surgery in South Carolina, as well as the first series of no-incision weight loss surgeries and the first laparoscopic surgery with a single incision.

    dr Balder has received numerous awards throughout his career, including being recognized as a surgeon in the American Society of Metabolic and Bariatric Surgeons' Center of Excellence by the Surgical Review Corporation and multiple Centers of Distinction awards from Blue Cross Blue Shield, United HealthCare, and Aetna. .

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    How much does a gastric sleeve cost in Mexico?

    Compared to other nations like the United States, the cost of a sleeve surgery in Mexico is the cheapest option available. When it comes to sleeve surgery in the United States, the average patient reports paying up to $20,000, but in Tijuana, Mexico, the average patient reports spending between $3,995 and $7,000 for the full quality weight loss treatment.

    Weight loss surgery at umc for medicaid patients

    Louisiana Medicaid Weight Loss Surgery - MedicAidTalk.net (3)

    The doctors at the university hospital recently informed potential patients about a new weight loss program.

    So many people are interested in this new opportunity that the class was filled immediately on Wednesday, but the new clinic will have future classes you can attend.

    For years, Weight Loss Wednesday has highlighted the many success stories associated with bariatric surgery. Studies show that surgery to reduce the size of the stomach and alter hunger hormones is more effective for weight loss and long-term health than diet and exercise alone.

    But for people in Louisiana who couldn't afford the $20,000+ price tag or who didn't want to pay their private health insurance, this often life-saving procedure was taboo. Now, for the first time, it's available to people on Medicaid.

    "I truly believe that by bringing this service to this patient population, we will transform the landscape of healthcare in Louisiana," said Dr. Christopher DuCoin, Director of Bariatric Surgery at UMC and Chief of Bariatric and Minimally Invasive Surgery at Tulane.

    More than 600 people are already waiting for the doors of the new clinic and operating room to open.

    "It's amazing. There's literally nothing that won't help weight loss," added Dr. Added DuCoin.

    And lives are saved as people live longer and better lives.

    The UMC program can also advocate for people who have private insurance that will not pay for the surgery.

    The dates of the free seminars until the end of 2018 are as follows:

    Wednesday, June 13 at 5:30-6:30

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    What Weight Loss Procedures Does Medicaid Cover?

    In most cases, Medicaid covers gastric banding, gastric sleeve surgery, and gastric bypass surgery. Not only are these easily covered by Medicaid, but they are among the most recommended surgeries. In certain situations, these are accepted as medically vital to the patient's life and well-being.

    Gastric bypass makes the stomach smaller and bypasses part of the intestine. Therefore, you eat less and the food is also sent directly to the lower part of your intestines. This bypass reduces the absorption of nutrients and calories. As a result, it reduces food intake and also helps in weight loss. In lap band surgery, the upper part of the stomach is covered with silicone balloon bands. This reduces the space for storing food. The entrance to the stomach also becomes smaller. The procedure is less invasive compared to others and is performed laparoscopically. Also, it is preferable because it is easily reversible and the band can be adjusted. Finally, gastric sleeve surgery creates a smaller, sleeve-shaped stomach. Because food doesn't have much room to sit, it easily enters the intestines. Thus, it also reduces food intake and calorie intake.

  • FAQs

    Will Medicaid pay for weight loss surgery in Louisiana? ›

    Louisiana Medicaid covers bariatric surgery, consisting of open or laparoscopic procedures that revise the gastrointestinal anatomy to restrict the size of the stomach, reduce absorption of nutrients, or both. Coverage of bariatric surgery requires prior authorization.

    What do I say to qualify for weight loss surgery? ›

    Learn your body mass index

    Morbid obesity is defined as a BMI score of 40 or more. You typically qualify for bariatric surgery if you have a BMI of 35 or greater, with specific significant health problems like Type 2 diabetes, sleep apnea or high blood pressure.

    What is a letter of medical necessity for weight loss program? ›

    I feel this patient would benefit from weight loss surgery because (he/she) has been unsuccessful losing weight with other diet methods, and (his/her) medical conditions will become life-threatening if (he/she) does not get help getting (his/her) weight under control. I appreciate your consideration for approval.

    Does Louisiana Healthcare Connections cover weight loss surgery? ›

    Thank you for contacting us with your interest in weight loss surgery. Fortunately, your insurance DOES cover the procedure that we offer, however we must prove that it is “MEDICALLY NECESSARY”.

    How much does weight loss surgery cost in Louisiana? ›

    Select any of the procedures below to view detailed cost data and provider comparisons.
    ProcedurePrice Range
    Duodenal Switch Cost Average$18,000 - $49,500Free Quote
    Single Anastomosis Duodenal Switch (SADI) Cost Average$15,300 - $42,000Free Quote
    Lap Band Surgery Cost Average$4,700 - $12,700Free Quote
    2 more rows

    What does Medicaid cover in Louisiana? ›

    LaCHIP provides Medicaid coverage for primary care doctor visits as well as preventive and emergency care, immunizations, prescription medications, hospitalization, home health care and other health services.

    Is it hard to get approved for weight loss surgery? ›

    To be eligible for weight-loss surgery, you must meet the following requirements: Have a body mass index (BMI) of 35 or higher, or have a BMI between 30 and 35 and an obesity-related condition, such as heart disease, diabetes, high blood pressure or severe sleep apnea.

    Why do people get denied for weight loss surgery? ›

    But why might a patient not qualify for bariatric surgery? BMI: First and most obviously, they simply may not have a BMI that is high enough. A BMI of 35 or more with one or more obesity related conditions or BMI of 40 or greater regardless of obesity related conditions is required to have surgery.

    Can you get gastric bypass at 200 lbs? ›

    To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40).

    Does Medicaid pay for implants in Louisiana? ›

    Does Medicaid Cover Dental Implants in Louisiana? Louisiana has limited coverage for dental care. That means you can only get an implant if it's medically necessary.

    What is a lap band for weight loss? ›

    Laparoscopic gastric banding is surgery to help with weight loss. The surgeon places a band around the upper part of your stomach to create a small pouch to hold food. The band limits the amount of food you can eat by making you feel full after eating small amounts of food.

    Does Medi Cal pay for gastric bypass surgery? ›

    Medicare and Medi-Cal

    Medicare covers some bariatric surgical procedures if you meet certain conditions related to morbid obesity. Recently, Medicare expanded its coverage to include vertical sleeve gastrectomy. Medi-Cal only covers the cost of surgery in certain California counties.

    Does Medicaid cover prescriptions in Louisiana? ›

    COVERED SERVICES:

    Covers prescription drugs, except: Cosmetic drugs (Except Accutane); Cough & cold preparations; Anorexics (Except for Xenical);

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