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Bcbs Federal Insurance Requirements For Lap Band



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I am terribly concerned about the documentation required by BCBC Federal regarding 2 years of documented morbid obesity. I do not have the documentation for the 2 years as I have just recently met the BMI required for the surgery. Does anybody have experience in the past with BCBC Federal in regards to this requirement? Are they strict with meeting all the requirements?

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For BCBS Federal, I had to do a 3 month supervised diet. I had already had documentation about having sleep Apnea and that I was on blood pressure medicine. (Which i had been on for a while, more then 2 years.) I'm not sure what your circumstances are but, after my paperwork was submitted, I heard back within the week that I was approved. From what I understand BCBS Federal is actually pretty good at approving, and fast with responses. Good Luck!!

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I have BCBS FEP Standard. My bmi was over 50. I was approved with no comorbidities without any kind of supervised diet. My surgery was in March 2011.

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Thank you for the prompt response. I do have 2 of the co-morbid condtions. I am hopeful that the surgery will be approved the 2nd week of December. I will post back on the results of the approval and my progress. Thanks again

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I'm sure you'll have no problem getting approved!!! Good luck, hope to hear some good news soon!

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I'm sure you'll have no problem getting approved!!! Good luck, hope to hear some good news soon!

HELLO fellow co-wrkers

It is MUSIC to my ears!!, going for final weigh in in 30 minutes :rolleyes: .. and love the fact that every body is reporting swift approvals from FepBLUE- I have Basic, As for the 2 years, I hear you just need some weight in data from some Dr. ANY Dr. I have even heard people submit pictures, think hard what you may have to prove you were over 35 BMI.. with comorbidities, the last 2 years. Does your DL state it?

OPM just sent a little preview, that premium prices going up a little, but benefits would basically stay the same.

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I am terribly concerned about the documentation required by BCBC Federal regarding 2 years of documented morbid obesity. I do not have the documentation for the 2 years as I have just recently met the BMI required for the surgery. Does anybody have experience in the past with BCBC Federal in regards to this requirement? Are they strict with meeting all the requirements?

I would call BCBS Fed and ask them how strict or liberal they are for the two year requirement for proof of obesity. Unfortunately for me, it wasn't hard to get that done.

I am concerned, though, about the letter you have to write for weight loss attempts over the last year. I keep getting reassured that they are easy to get approval from.

My ins co-ordinator says I have all of the documentation just have to lose the required weight before they will send it to BCBS. Hoping to be down to required weight by Nov 1st and

get it scheduled in Dec. Will take any date in Dec including Christmas or New Year's Eve, lol

All the best to you, hon. Keep us posted.

Melinda

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I was approved by Fed BCBS (standard) and I am waiting for my surgery date. I provided them with 2 years of my PCP's office notes which showed my weight history as well as 8 months of "supervised" dieting (when I was on diet pills). My surgeon's insurance coordinator submitted my paperwork on a Thursday and approved by Monday. I just need to have an endoscopy with my surgeon and (assuming no issues) will have my surgery date scheduled the next day.

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in my dealing with feb bcbs the personnel who are in the know is care mgmt..when you call customer service with questions ask them to confrim with care mgmt since they do the approvals i just got banded less than 12hrs ago....so lets say in you went the dr for whatever in dec 2009 you were 250lb and and oct 2010 you went and 255lb that would be acceptable to meet the requirements because care managemt would know based of the bmi scale you were 40% or more....hopes this helps once my packet was submitted took less than 24hrs to approve..gl to you

I am terribly concerned about the documentation required by BCBC Federal regarding 2 years of documented morbid obesity. I do not have the documentation for the 2 years as I have just recently met the BMI required for the surgery. Does anybody have experience in the past with BCBC Federal in regards to this requirement? Are they strict with meeting all the requirements?

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in my dealing with feb bcbs the personnel who are in the know is care mgmt..when you call customer service with questions ask them to confrim with care mgmt since they do the approvals i just got banded less than 12hrs ago....so lets say in you went the dr for whatever in dec 2009 you were 250lb and and oct 2010 you went and 255lb that would be acceptable to meet the requirements because care managemt would know based of the bmi scale you were 40% or more....hopes this helps once my packet was submitted took less than 24hrs to approve..gl to you

Thanks, I thought about that situation as well. I am hoping to have the surgery during the last 2 weeks of December. But, I may have to wait until January to have the 2 years to reflect the weight needed to meet the requirement. It appears your surgery went well.

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Remember the new year starts new rules, from OPM they said the is premium was going up a bit but not too many changes in benefits. . I have a manomety test to take next tuesday and if all is well I can submit my paperwork! this 2 days turn around is GOOD NEWS - I am ready!:lol:

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Remember the new year starts new rules, from OPM they said the is premium was going up a bit but not too many changes in benefits. . I have a manomety test to take next tuesday and if all is well I can submit my paperwork! this 2 days turn around is GOOD NEWS - I am ready!:lol:

I talked to Blue Cross last week and they said off the cup that the benefit structure is not changing much. I am working hard to make it happen for me in Dec. Hope everything else gels for you. Let us know how your test goes.

Melinda

Remember all, open season starts around Nov 14th

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I called Fedblue last nite and asked how long my diet and pre- requisites good for? I completed everything by Oct 4th. She said NO time frame, which I wonder if that is true. I know I'm not that far out, but just wondered if there was a cut off and they say, sorry you took too long and you must start all over again.

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I called Fedblue last nite and asked how long my diet and pre- requisites good for? I completed everything by Oct 4th. She said NO time frame, which I wonder if that is true. I know I'm not that far out, but just wondered if there was a cut off and they say, sorry you took too long and you must start all over again.

I can't imagine that they would make you start over.....I would think it would be good for a year at least

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I am terribly concerned about the documentation required by BCBC Federal regarding 2 years of documented morbid obesity. I do not have the documentation for the 2 years as I have just recently met the BMI required for the surgery. Does anybody have experience in the past with BCBC Federal in regards to this requirement? Are they strict with meeting all the requirements?

Nine weeks down and 3 to go for my final weigh in with my primary care physician and the approval process will begin. I can't wait!

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

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