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BCBS Federal Employee Program Basic

I started this process back on June 16, 2016. I was denied first in August of 2016 then again in December of 2016 after I tried to appeal by myself. After that I was getting frustrated so I decided to use Lindstrom obesity advocacy appeals. They sent out the appeal letter to OPM on March 9, 2017 and I was approved on March 17, 2017. I just wanted to say if your having a hard time do not give up hope! Also you might want to talk to them if you have been denied as well.

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Keenikwe,

i have Fep Blue as well, yet it says you only need 3 months of medically supervised diet/nutrition.... at least that's what I see when I look at the 2016 & 2017 book online.

are you fepblue standard or basic? I am standard

  • Author
On 7/12/2017 at 0:06 AM, Keenikwe said:

I have BCBS FEP and my program mistakenly thought I was compliant after 3 months... I got denied and told to do the full 6 months. I have my final weigh-in/NUT appt in 6 days. Then I'll be able to see how long it takes to be approved; hopefully! Crossing my fingers!

I only had to do three months. The insurance company just does not want to pay, and will find any reason to deny you.

The 2016 and 2017 basic option standard benefit clearly says 3 months. Have you tried logging into your fepblue account to send them a secure message? They're great about answering quickly. It sounds like they made a mistake.

Sent from my XT1254 using BariatricPal mobile app

  • 2 weeks later...

Hey Bri,

I just got denied and in process of appealing myself. My BMI is 39.51, I am pre diabetic and have a few commorbidities like hypertentension, and few others. I have always been betwen 36-40 BMI for the past few years and its been hard as hell. My mom has diabetes, and grandma passed away from obesity and alzheimers. I wrote a 4 page letter, included my doctor's letter of medical necessity, 2 years of work out history, record of different weight loss drugs ive taken in the past 3 years and hope I do not get denied. Can I ask how long the process was to use Lindstrom obesity advocacy appeals and how much did it cost?

Can you please guide me? I really need your wise advise...

Thanks

Becky

I just found out I was approved, I'm still waiting for my surgeons office to call, but I had checked with BCBS and they said I've been approved. I have standard BCBS FEP plan.


I'm in the process of being screwed over by BCBS FEP. My original July 31 surgery day was canceled and my next one on August 23 looks like it won't happen either.

Looking forward to yelling at some people at BCBS and my surgeons office tomorrow.


  • Author
On 8/7/2017 at 10:48 PM, BGrundee said:

Hey Bri,

I just got denied and in process of appealing myself. My BMI is 39.51, I am pre diabetic and have a few commorbidities like hypertentension, and few others. I have always been betwen 36-40 BMI for the past few years and its been hard as hell. My mom has diabetes, and grandma passed away from obesity and alzheimers. I wrote a 4 page letter, included my doctor's letter of medical necessity, 2 years of work out history, record of different weight loss drugs ive taken in the past 3 years and hope I do not get denied. Can I ask how long the process was to use Lindstrom obesity advocacy appeals and how much did it cost?

Can you please guide me? I really need your wise advise...

Thanks

Becky

Hi Becky!

On my first appeal I wrote a letter too. I do not think they will care, there main thing is saving them money any way they can. when I used lindstrom it was a very quick and painless process for me. I sent them over all of my weight history even history from my pediatrician to show that I have always struggled with weight. They sent in my appeal paper work to OPM on March 9 and I was approved by March 17. They are very nice and give great advice, I would suggest calling them because that is free.

Thought I would say that I just got my approval today. Never got a denial but had a couple extra hoops and it took 4 days once they got the additional paperwork


Kate,

Congratulations!

what do do you mean you had to do extra hoops? Did you get a separate letter giving you a conditional approval if you complete these extra tasks?

What kind of extra hoops did they want you do do?

My surgery was originally scheduled for July 31 and two business days before, my doctor called because insurance just let them know that they also wanted their dietician to submit stuff they didn't bother detailing to me and that my psychiatrist needed to submit a letter saying he has been and will continue to treat/Medicate me, he supports my surgery, and have had no history of substance abuse for the year prior. This was all on top of the $280ish cash I paid for my psych evaluation.

It was all crap considering they've been paying for my psych and meds monthly since I was 18.

I was worried they would somehow expect me to prove the 1 year of attempted and failed weight loss but I didn't have to provide anything for that.


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