GEHA or fed bcbs?

[Mandat89 28]

Hi

I saw my doctor a year ago about bariatric surgery. I have seen him two times after that about the weight. I currently

Have GEHA and their requirement is 6 months of supervised diet. I brought the paperwork to my doctor thinking it would be all set since we had already attempted the weight loss. Now I'm thinking I probably won't be able to get approved by them anytime soon...I'm assuming the six months would have to start now and I would have to go every month for 6 months? The visits I've had won't go toward the six months?

Is bcbs federal a better option for me since they only require 3 month supervised diet? Open season is November and I'm wondering if I should just switch.

[April0452 4]

Fed BCBS Basic. 4 months and approved waiting on surgery date.

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[sarahblu 179]

I have GEHA and went through the 6 months. I was totally irritated in the beginning...just when you make the decision, they tell you, nope...you have to wait 6 months. The surgeons office I used, took care of everything. They had a nutritionist in house, that I saw every month that counted towards my monthly visits. After my last visit if was all submitted to GEHA and they approved me in 2 weeks. I wasn't very patient but now I am glad I had the time to learn and ask questions. The visits have to be consecutive or they won't count. As long as it's supervised and they follow the required protocol, it should be fine.

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[Mandat89 28]

Thank you so much for your info. I appreciate it. I'm in the same

Boat you were in. I decided this a long time ago, but tried one more time to lose weight myself. Last month I finally thought to myself, it's time to make things happen and I decided to go through with it. It's a pain that I have to wait six more months, but I'll take this time to learn and start working on my lifestyle change.

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[Mikkos 22]

Hello Everyone,

I am new to this forum and was seeking more information about GEHA approval. I started my 6 month diet in September 2016, and February 6th will be my last visit with the dietician. I've heard that some insurances don't count the visit toward the 6 visits, has anyone had that problem with GEHA? Also, has anyone been denied due to not losing weight? I started at 287, and currently weigh 283, so I'm nervous they won't approve it. I don't have any co-morbidities, so I figured I would be denied anyway if I lost too much weight. If anyone has anymore experiences with GEHA, I would appreciate the info. Thanks in advance!

[Mikkos 22]

For anyone else that may have GEHA, it only took about 1 week for approval. I just found out this morning that my surgery was approved. My doctor's office sent the request on 2/10/17, so it only took 10 days. Also, in my previous post I was concerned about my first dietician appointment not counting toward the 6 month diet, as many insurances require 6 follow ups after the first appointment. I had my first visit on September 2, 2016 and my last on February 6th, 2017, and then approved today. So, I'm very happy with the process and quick turn around time from the insurance.

[Mandat89 28]

For anyone else that may have GEHA, it only took about 1 week for approval. I just found out this morning that my surgery was approved. My doctor's office sent the request on 2/10/17, so it only took 10 days. Also, in my previous post I was concerned about my first dietician appointment not counting toward the 6 month diet, as many insurances require 6 follow ups after the first appointment. I had my first visit on September 2, 2016 and my last on February 6th, 2017, and then approved today. So, I'm very happy with the process and quick turn around time from the insurance.

How did you get the approval? By mail? Congrats!!


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[Mikkos 22]

17 minutes ago, Mandat89 said:

How did you get the approval? By mail? Congrats!!


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I found out from a phone call from my doctors office this morning. But I started calling GEHA every few days to check the status. They would only tell me it was pending approval, and that I would be notified via mail.

[Matt Z 4,139]

I've got GEHA as well. I'm trying my hardest NOT to have to do the 6 months of dieting... because I've had a band for 5 and a half years now. That should count in my opinion.

[GassyGurl 428]

I would compare total costs too. I have fepblue basic and it seems like the coverage is excellent. $40 copays for specialists. No deductible. If surgery is done at a blue distinction center, it's $100 per day, max $500. Plus, 3 Mos (4 visits) of medically supervised weight loss with your pcp, 2 year history of being obese, nutritional assessment, no smoking, and evidence of failed attempts at weight loss. Compared to other people's requirements, it seems like fepblue is awesome.

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