Obesity can have many causes, including lifestyle choices, illness or injury, and genetic predisposition, and in the past, people suffering from obesity were often resigned to live a life of discomfort and poor health. Research completed in the past few decades has concluded that obesity greatly increases the risk of developing a wide range of illness, from cardio-vascular disease to cancer. Thankfully, bariatric surgery is an option available to tackle obesity and provide a path to health and wellness for those who have been found other treatments unsuccessful. Bariatric surgery changes how digestive organs process food, and sometimes, the stomach may be shrunk to reduce its capacity. Gastric bypass, lap-band surgery and gastric sleeve surgery are among the most common and successful methods of bariatric surgery.
Does Medicaid Cover Bariatric Surgery?
Medicaid is a healthcare program administered by each state that provides financial coverage for medically necessary treatments for individuals who meet their income requirements. In most cases, individuals covered by Medicaid services may be eligible to have some forms of bariatric surgery covered, but the catch is that the surgery needs to be deemed medically necessary in order to qualify. This means that an individual’s doctor usually must exhaust all other options prior to considering bariatric surgery, and a physician will need to demonstrate that bariatric surgery is necessary in order to limit or eliminate potentially life-threatening medical conditions. Someone seeking bariatric surgery coverage by Medicaid may be required to try various medications and other less-invasive options prior to surgery being considered as a covered expense by Medicaid.
Some people may also be able to receive supplemental benefits from Medicare if they are considered dual-eligibles. These are individuals who qualify for both Medicare and Medicaid services, and dual-eligibles may have the cost of bariatric surgery split between the two programs. If you are currently receiving benefits from either Medicare or Medicaid and would like to know whether you are qualified for dual-eligibility, speak to your current representative from either program to learn more about the regulations in your state.
Medicaid and Life After Bariatric Surgery
After having bariatric surgery, you may need to make lifestyle adjustments that include dietary changes and limitations on food consumption or the consumption of certain foods. Some medications may be required, at least temporarily, in order to help you adjust to the changes made by surgery. Medicaid patients may be able to receive coverage for post-operative care and follow-up appointments. It’s very important that you follow the advice of your physician and surgical recovery team to avoid the potential for future injury. All types of bariatric surgery come with a risk of complications, but with proper aftercare, you should be able to make a full recovery.
Discuss Lifestyle Changes as an Alternative to Surgery
As mentioned, while genetics certainly plays a part in the development of obesity, the first line of defense and treatment is usually to make lifestyle changes. This may include getting more exercise and changing your diet to include fewer processed foods and carbohydrates. What’s important in any type of major dietary change is to discuss any changes you are making with your physician. You may have a friend or family member who swears that a particular diet or supplement works to get rid of excess weight, but each person is different. What works well for someone else may actually end up causing you harm because of pre-existing conditions or unique medical issues, so review your options with a trained medical professional before embarking on any supplement, diet, or fitness routine.
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