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Federal BCBS paid for my sleeve 100%, minus the copayments for the hospital and my surgon!

If you have Federal Blue Cross Blue Sheild, you should be happy! I'm on my dads plan and he has the basic plan but they paid for my surgery 100%. The only thing I had to pay was a $200 copayment to my surgery and $175 for my copayment for the hospital. I orignally was going to do the band, but they don't cover implants and it would have cost me almost 3 grand. I'm so happy it was so cheap for me. I'm so excited for the future. I'm currently 1 week and 4 days post op, I've been on a liquid diet for 2 weeks and 4 days and I've lost 25lbs since I started my liquid diet. I'm so happy. I had such a horrible time trying to lose weight because of my knee and back pain made it almost impossible to exersice very much and I'm hoping once I get down under 200lbs, I hope the pain will fade since I assume it's my weight causing it since I've had test and x rays and all kinds of stuff and doctors can't find anything wrong with my knee or back. So fingers crossed!

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Federal BCBS Standard here. just want to follow this thread for future reference as I am early in my journey....

  • 2 weeks later...

I'm doing my 3 months do doc supervised weigh ins right now, one month left. I've done my nutrition consult and my psych eval.

How did you show you did 2 yrs old failed diets?

I brought in weight records from MD visits over the last two years, plus records from the medically managed weight loss program I was in last year.

I'm doing my 3 months do doc supervised weigh ins right now, one month left. I've done my nutrition consult and my psych eval.

How did you show you did 2 yrs old failed diets?

I brought in weight records from MD visits over the last two years, plus records from the medically managed weight loss program I was in last year.

I didn't have to show a history of trying to lose - they saw that I was obese for a period of several years and that was enough apparently. They never really seemed to even ask me that I recall. I may have volunteered that I had tried and lost about 40 on my own but then plateaued and didn't get any further but that was pretty much it. When they were looking at the documentation in my records, they said oh we can show the years of. Good thing is that my bariatric center and my clinic are affiliated and so each can see the records of the other. Maybe that made the difference for me???

Mine was fairly easy even though I am on the low end. There was an application the MD made me fill out and I had to list all previous failed diets. My primary also wrote them on his referral letter to the bariatric doctor and all of this went to the ins. co. I really didn't have to prove anything. They went on my word.

I have BCBS Federal as well. How many surgeons did you have? Originally I was told that I had to pay $150/surgeon, but today the Bariatric Coordinator at my surgeon's office said she "re-verified" my benefits, and I'm responsible for $200/surgeon.

Hey SweeTea,

I've been told that I am responsible for $250/surgeon and $350 for the hospital but they are still working through the insurance process (my surgery was May 12) so I'm not sure what will finally shake out...I have standard.

I have the Basic and my bill was $200 for the surgeon and $350 for the hospital. $550 in total.

I found out yesterday that the surgeon fee went from $150 to $200/surgeon bc of the setting (I will be in a hospital).

@@Rchobby513 did your hospital require a deposit? If so how much was it?

I found out yesterday that the surgeon fee went from $150 to $200/surgeon bc of the setting (I will be in a hospital).

@@Rchobby513 did your hospital require a deposit? If so how much was it?

No I was just asked for $175 co-pay when I was admitted.

Received my Explanation of Benefits for my surgery. My insurance paid everything except for my $250 co-pay for hospital admission!

  • 2 weeks later...

so exciting and nerve racking at the same time. I just got some medical history from 2009 showing I was over 40BMI. I haven't been to the dr. since then for 5 years. I am hopeful that all will play out my way. going through all the programs as well. fingers crossed when I get to that point.

On the FEP BCBS, did you wait for surgeon's office to contact you for setting up the 3 month of supervised weight lost program or how was that handled?

Also, what did you provide as evidence that attempts at weight loss 1 year prior to surgery was ineffective?

Retired from Federal service; My primary referred me to the Bariatric Program at the hospital. They established my program based on my coverage requirements and started me on a three month supervised diet. I had to provide two years worth of documentation that I had tried to lose weight on my own. My primary printed out a complete copy of his doctor's notes for the last two years. I went through with a highlighter and marked every place where my weight was measured or mentioned.

I also composed a letter detailing all of the different failed attempts with various well-known diets. In the letter, I also explained how my weight has affected my quality of life, my family history of morbid obesity, and how I expected the surgery to improve my health. Claim as many co-morbidities as you can. here is a list of conditions that the insurance companies consider

Obesity Comorbidities

To follow is a list of comorbidities (additional conditions or diseases) related to obesity which may help you in qualifying for weight loss surgery.

  • Family history of heart disease
  • Family history of stroke
  • Family history of diabetes
  • Family history of heart attacks
  • Hyperinsulinemia
  • Diabetes
  • High blood pressure
  • Coronary-artery disease
  • Hypertension
  • Migraines or headaches directly related to obesity or cranial hypertension
  • Congestive heart failure
  • Neoplasia
  • Dyslipidemia
  • Anemia
  • Gallbladder disease
  • Osteoarthritis
  • Degenerative arthritis
  • Degenerative disc
  • Degenerative joint disease
  • Recommended joint replacement from specialist
  • Accelerated degenerative joint disease
  • Asthma
  • Repeated pneumonia
  • Repeated pleurisy
  • Repeated bronchitis
  • Lung restriction
  • Gastroesophageal reflex (GERD)
  • Excess facial & body hair (Hirsutism)
  • Rashes
  • Chronic skin infections
  • Excess sweating
  • Frequent yeast infections
  • Urinary stress incontinence
  • Menstrual irregularity
  • Hormonal abnormalities
  • Polycystic ovaries
  • Infertility
  • Carcinoma (breast, colon, uterine cancer)
  • sleep apnea
  • Pseudotumor cerebri
  • Depression
  • Psychological/sexual dysfunction
  • Social discrimination
  • Premature death in the immediate family

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