Medicaid prior authorization for transportation suddenly being denined over a year later? Is there anything I can do?
I'm not sure where to ask this, or who to ask, as I have been given the run around with my insurance company.
Back in 2023 I was given prior authorization to join a weight loss program, non surgical bariatric program, because I am super morbidly obese & had trouble losing weight & other systemic issues impacting my overall quality of life, including needing surgery for something else, but getting my hormones in check & reducing my size would help care for that, etc. They were pushing bariatric surgery, but I wanted to try to do what I could naturally first, since I had to eat a specific diet, take certain medications etc, before opting for surgery, as I didnt want 2 surgeries back to back.
I mentioned I had no way to get there due to the distance & no vehicle etc as they have 2 facilities and one is an hour away for conveience to touch base, and the other that I am required to visit ever 3 months for body scans to keep up with muscle, bone, fat etc, is 1.5 hours away, and I was assured rides would be covered since it was deemed medically necessary for health purposes…and they have been covered since the start of the program in 2023 up until my most recent appointment in December 2024. I called to set up a ride for an appointment coming up in March, and the rep claims she couldn't get a ride set up for me because "you were never supposed to get rides anyways, and she doesn't even know how previous reps even set it up, because there isn't even an option & the system rejects the reason for 'scheduling a ride for weight loss/nutrtion 'programs." So I was unable to schedule a ride this time, and now have to figure out a way to get to the program to stay in compliance. The problem is, if I miss any appointments, two at the most, I am dropped from the program…and this feels really messed up because it's not really my fault? I'm not sure what to do. Transportation didnt let me speak to a supervisor, Im not sure if they even have a supervisor I can speak to or if the rep was just being difficult. So I called my insurance to let them know what was happening, and the rep helped me by letting me speak to what I think she called a case manager within the insurance department. She didn't help much & tried contacting my care coordinator through the insurance, who told her to leave a message with my call back number because she was busy with someone else..which is understandable. But it's been 7 days since this incident and I have called 2x and she (care coordinator) hasn't returned my call, and I don't know what to do.
Is anyone familiar with transportation services through Medicaid? If I received prior authorization for something deemed medically necessary for treatment, wouldn't that cover transportations still, even if it's not typically covered? I'm not sure who else to contact for further help, or what would happen as far as coverage for services already rendered for over a year, if I am kicked out of the program.
submitted by /u/TheCuri0usWatcher
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