Monday, October 20, 2014

Saturday, March 12, 2011 Kathi May, Community Member, asks

Q: Does Alabama Medicaid cover the cost of gastric bypass?

Answer This
Answers (2)
Phat in My 40's, Health Guide
3/21/11 9:21am

Hi Kathi,


Here is a listing (pdf) of what obesity-related services are covered by different state's medicaid departments.  It appears that bariatric surgery is covered under Alabama Medicaid (one surgery/patient) if supporting evidence is documented.  Here is the specific information:


Covered Procedures:
Gastric Bypass and Lap Band surgeries. Agency covers one surgery/patient.
Prior Authorization: Beneficiary must have a
1) BMI consistent with morbid obesity diagnosis;
2) Presence of obesity-related medical complications;
3) Planned adjunctive therapy before and after surgery;
4) Physician-patient risk benefit counseling;
5) Minimum 6 months physician-supervised weight loss efforts BMI consistent with morbid obesity diagnosis.8


If you go to the pdf, you will find links to related documents at the bottom of each page.  You may want to check those out.



My Bariatric Life, Health Guide
3/23/11 9:46pm

Kathi, You'll also need to locate a surgeon who will accept Medicaid in Alabama for the gastric bypass. Have you found such a surgeon?


Be aware that Medicaid will likely require you to follow a 6-mos physician-supervised diet and also may require a psych evaluation. This is no different from other insurers -- some have these same requirements (while others do not).


I was fortunate that my insurance company paid for my surgery without the 6-mos waiting period. I say lucky because when I made up my mind ot get the surgery, I wanted to have it then, when I was mentally prepared. I actually backed out of my first surgery date because I was scared. Well, I went back a few months later and had the surgery. It was defiantely the right decision for me. My overall health and well being is greatly improved and I am sure that I have added years to my life span.


Good luck with everything.

Answer This

We hope you find this general health information helpful. Please note however, that this Q&A is meant to support not replace the professional medical advice you receive from your doctor. No information in the Answers above is intended to diagnose or treat any condition. The views expressed in the Answers above belong to the individuals who posted them and do not necessarily reflect the views of Remedy Health Media. Remedy Health Media does not review or edit content posted by our community members, but reserves the right to remove any material it deems inappropriate.

By Kathi May, Community Member— Last Modified: 03/23/11, First Published: 03/12/11