Does medicaid share of cost in Florida cover gastric bypass?

Yes, Florida Medicaid covers gastric bypass surgery for individuals who meet certain criteria, including:

1. Medical Necessity: Gastric bypass surgery must be deemed medically necessary to treat severe obesity and related health complications.

2. Body Mass Index (BMI) Requirement: Individuals must typically have a BMI of 40 or higher or a BMI of 35 or higher with associated obesity-related health conditions, such as sleep apnea, diabetes, heart disease, or severe joint pain.

3. Pre-Authorization: Prior authorization from Florida Medicaid is required before gastric bypass surgery can be performed.

4. Coverage Limitations: Medicaid coverage may have specific limitations, such as the number of surgeries covered or requirements for medical consultations and follow-up care.

5. Network Providers: Gastric bypass surgery must be performed by a network provider or a medical facility approved by Florida Medicaid.

It is important to note that specific coverage details may vary and can be subject to change over time. Individuals considering gastric bypass surgery under Florida Medicaid should consult with their healthcare provider and contact their local Medicaid office for the most up-to-date information and requirements.