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

BCBS Fed?????



Recommended Posts

unfortunately i don't know the answers to your questions but maybe someone else will come along who does

Share this post


Link to post
Share on other sites

I have prior-approval to have surgery January 13th (BCBS Federal). I was told fills are included. You just have to pay your specialty physician co-pay. I did have to wait for about six weeks to get my approval from the insurance. I have a BMI of 46.6 and no other health problems. I did have to submit that I'd tried conventional weight loss methods. I really didn't have much proof. I wrote a letter and also got my family doctor to write a letter saying I've been overweight for 14 years and tried WeightWatchers many times. My doctor's office required me to do a psych eval before scheduling me, which took me a month to see him too. I've been working on this since August 2008. I got approved in October. They give you 6 months from when you get your approval to have it done. So I'm finally scheduled on the 13th, and I'm so excited. It is worth using insurance. My doctor's office and hospital charges $17 thousand without it! Hope this helps.

Maybell

Share this post


Link to post
Share on other sites

I am a federal employee with BCBS Fed Basic. The insurance has the BMI/Morbidity restrictions that you must meet. My BMI is 41, but no co-morbidities.

The individual doctors are the ones that set the requirements as far as the Psych Eval and other things. BCBS Fed Basic doesn't require a 6 month weigh in....once I got all the things complete the doctor wanted my paperwork was sent to BCBS and I was approved in about 5 weeks and scheduled for surgery.

BCBS gives you a nurse that is your case manager and you call them personally with issues from lengthening your stay to payment problems.

I think you would be hard pressed to get it worked out from where you are.

If I were you, I would cancel the surgery date and go thru the proper channels and get insurance to pay for it. Remember federal plans drop children on their 22 birthday whether they're in school or not...except in cases of mental or physical conditions that make you dependent.

GOOD LUCK:tt1:

Share this post


Link to post
Share on other sites

I got aproved less than a week after we asked the surgon to submit the paperwork I turn 22 in mid feb but will be using cobra for a while

Share this post


Link to post
Share on other sites

the surgery was postponed till next Friday as i apparently have an elevated PT count

:)

Share this post


Link to post
Share on other sites

I called another surgeon and went in for consult. The consult took 3 hours. I left the office with an office approval and in 45 minutes they called my cell phone telling me that insurance had approved me and they had my approval number/code. I was shocked. Surgery is set for Feb 16th. Oh yea, I am the one with BCBS fed and was frustrated with the 6 month thing. Turns out Penrose requires it, not the insurance.

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

    ×