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

Bcbs federal



Recommended Posts

Hi everyone

I have Fed BCBS

In 2015 my BMI was 37-38

No comorbidities 2015

2016 BMI 42 sleep apnea

Planning to have sergury in February or March 2017.

I scared I'm not going to be approved because of low BMI 2015. Help

Sent from my SM-J700T using the BariatricPal App

My BMI was 38 in my history, they actually submitted 1 weight for each of the 5 years and my most recent BMI was 40. Approved 14 days after submission! Good luck.

Sent from my XT1585 using the BariatricPal App

Share this post


Link to post
Share on other sites

I don't have anything to add, but I have FEP Blue Basic and had my surgery in October. The process was fairly smooth, and I got my approval back in a very short time. I didn't have to prove anything with food logs or my gym membership. Best of luck to all of you.

Share this post


Link to post
Share on other sites

I found weights in a file but they are slightly under the 35 bmi, I have 3 comorbidities that I am linking into this with my bmi of 36.6. My Dr agrees that the surgery will be beneficial and I should move forward. I nervous that the insurance won't go for it because of the other numbers.

Anything under 35 BMI do not send to insurance their guidelines are exact with no wavering, whatever you do going forward do not let your BMI drop under 35. You get weighed prior to surgery.

Sent from my iPad using the BariatricPal App

Share this post


Link to post
Share on other sites

Hi everyone

I have Fed BCBS

In 2015 my BMI was 37-38

No comorbidities 2015

2016 BMI 42 sleep apnea

Planning to have sergury in February or March 2017.

I scared I'm not going to be approved because of low BMI 2015. Help

Sent from my SM-J700T using the BariatricPal App

As long as you don't fall under 35BMI ur ok. Read your policy it's in there. Don't be scared. As long as you follow the guidelines your ok. Good Luck!

Sent from my iPad using the BariatricPal App

Share this post


Link to post
Share on other sites

I am going through the process now . 1 yr food log and gym membership ? Are those required ? Everything else looks good. My Dr is requesting endoscopy / upper GI .

I am planning to get the sleeved.

Hopefully around March or April 2017

What about Short term Disability insurance / FMLA ?

Sent from my SM-J700T using the BariatricPal App

Gym membership I can tell you is not sufficient, ur food logs will ok if it's medically supervised by a dietitian. Someone posted the requirements for 2017, read that to be certain exactly what you need.

Happy Journey!

Sent from my iPad using the BariatricPal App

Share this post


Link to post
Share on other sites

I got a from the lady at the hospital yesterday to let me know she will be summit my paperwork to Fed BCBS today for approval. It's usually takes 15 days to here from back them. Wish me luck.

She said if everything go as planned I will have my sergury mid February.

Share this post


Link to post
Share on other sites

I think the hardest one for me was to show I failed at weight loss in the year leading up to my meeting with the surgeon as they wanted consecutive weigh in with my pcp who had me on phentermine. I was traveling a lot a skipped a month weigh in over six months. I provided my airline ticket, etc. When all was said and done it took bcbs fep 2 days to approve me.

Sent from my SM-N910T using the BariatricPal App

Share this post


Link to post
Share on other sites

When everything was done ans you were approved, how much did you pay out of pocket for the procedure? Anyone?

Share this post


Link to post
Share on other sites

I got a from the lady at the hospital yesterday to let me know she will be summit my paperwork to Fed BCBS today for approval. It's usually takes 15 days to here from back them. Wish me luck.

She said if everything go as planned I will have my sergury mid February.

How did things turn out? Are you in NoVA? It sounds like you're about 5 weeks ahead of me in the process.

My surgeon's office hasn't asked for that much information from me yet they keep assuring me they have it under control...I'm struggling to believe this is as important to them as it is to me.

Sent from my VS986 using the BariatricPal App

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

    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 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

    ×