my father is a fed employee and I'm under his plan

we were going to pay out of pocket because everyone told us that to get approved for insurance we had to go on a 6 mo diet and we did not want to do that so my surgery date is 1/9/09 but i now see on this board that BCBS fed does not require a 6 mo diet but in 09 will require pre certification what exactly does this mean????

oh i forgot to add that my bmi is 51

thanks in advance Liz

Edited December 17, 200817 yr by EmpressLizBunny

I took no offense to your comment and will post my own. Sorry about the hijack, didn't mean to do so. Thanks for the comment!

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

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:

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

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

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.