Jump to content
×
Are you looking for the BariatricPal Store? Go now!

BCBS Federal: share your experience!



Recommended Posts

Hello to all....I am in the process of the pre-approval 3 month appointments with BCBS Federal. I am using Bluepoint Surgery Group in Northern VA.

Can anyone share your experience and tell me if there are any pointers in receiving approval? Were you turned down? Why and what did you do?

Thanks so much!

Share this post


Link to post
Share on other sites

With a BMI of 40.1 and several co-morbidities, I was approved by BCBS Federal Employee two days after my packet was submitted.

Share this post


Link to post
Share on other sites

Thanks to you both! Joat@@joatsaint the links are a great help.

S

Share this post


Link to post
Share on other sites

Hi Scoutsmom! I'm using Bluepoint as well...who is your doc? I have Dr Halmi. My experience has not been great, but that is because when I started my BMI was < 40 and BCBS did not accept my co-morbidities. It's a long story. I've been dealing with this since last March. (i am sure I am in the minority with the length of time it has taken; many of the problems were due to a comedy of errors on BP's part, & I switched surgeons yada yada yada)

Fast forward to present, I am waiting to hear on my last appeal. Other than that, they readily accepted my 3 month supervision & all other tests, etc. btw do you have Standard or Basic option? I have Standard. From what I've read on this forum & others, BCBS usually approves expediently if BMI > 40, & certain co-morbidities.

Good luck!

Share this post


Link to post
Share on other sites

Hi Peteyrulz,

I met with Pourshojae and liked him. But thinking of switching to Moazzez due to great feedback about him that I have read on this forum. I have BCBS Federal.

My BMI is under 40, which is why I am trying to insure I do everything possible to document the co-morbidities. I have a sleep study this week. Any thoughts on how to best document or present the co-morbidities so they are not rejected?

From what I can gather, Pam in the Fairfax office is the most knowledgeable and helpful.

Thanks for your reply!

Share this post


Link to post
Share on other sites

I have BCBS federal. My starting bmi was 36 with high blood pressure and later diagnosed with GERD. Took the sleep study but no apnea or abnormalities. There is no requirement to loose weight during the 3 months. I actually gained a few! Had no problem with approval because my history of hbp was well documented through years of treatment. I was approved in 5 days.

Share this post


Link to post
Share on other sites

Hi Scoutsmom! I'm using Bluepoint as well...who is your doc? I have Dr Halmi. My experience has not been great, but that is because when I started my BMI was < 40 and BCBS did not accept my co-morbidities. It's a long story. I've been dealing with this since last March. (i am sure I am in the minority with the length of time it has taken; many of the problems were due to a comedy of errors on BP's part, & I switched surgeons yada yada yada)

Fast forward to present, I am waiting to hear on my last appeal. Other than that, they readily accepted my 3 month supervision & all other tests, etc. btw do you have Standard or Basic option? I have Standard. From what I've read on this forum & others, BCBS usually approves expediently if BMI > 40, & certain co-morbidities.

Good luck!

did you have your surgery with Dr. Halmi? Or are you still in approval process? I just started the revision process with him.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • 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.
      · 0 replies
      1. This update has no replies.
    • 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

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

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

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×