Tell me your experience with BC/BS Federal. I am now terrified.

We have BC/BS Federal and am told that they do not approve RNY until AFTER the surgery! I am more worried about personal bankruptcy than the actual surgery. I have Dr. Patterson, and a surgery date of July 13. BC/BS Fed. says that you need a "pre-approval" before a hospital stay....but how can I get that if they won't approve surgery beforehand? Please tell me all and anything you know about this specific plan. Thank you.

I have BCBS Federal and they covered the surgery and the hospital. Yes, they do not pre-approve anything. I made sure that the hospital was a preferred provider. Also, Dr. Patterson and Dr. Hong are preferred providers. My surgery was completed April 4, 2005 and BCBS paid everyone by June 1, 2005. I too was worried, but as long as you are over 18 and over 100 pounds over the normal weight, the plan stated that it would be covered. The first reply from BCBS was that they denied all the expenses pending the doctor's notes. Once they received the doctor's notes they started paying. It took 2 months - but BCBS finally paid all but my portion. I hope this info helps you. And good luck with your surgery. It is worth it!! Lara

Lara: Our stories are so similar! I weigh just about what you did when you started (I am 5'5") and I started this process in Jan or Feb of this year, plus, we have the same insurance. Tell me, what was YOUR portion of this? We had to pay for the dietician and physical therapist at the Obesity Institute, but fought for the RN physical and got that one paid for. srn(rose) I have a feeling I am going to be talking with you alot, if that is okay.

I too have BC/BS Federal and haven't had any problem with them paying. I'm still pre-op, but the only thing I have had to pay is my copays and for the nutritionist. Good luck!

There are a couple of people like us who have BCBS FEP and they all have explained that the insurance will pay except for the nutritionist. I know it is disconcerting that we have to have the surgery before we know that they will pay - but they do come across. They covered the physical therapist as I do have arthritis. We are here for you and any questions we can answer. Good luck on your journey. Lara

Lara: Here's a new question: I went for my first consult with Dr. Patterson....we have the pre-op testing to do, and the surgery. I just received a bill from BC/BS that says that I am responsible for her charges.......... Ahhh! Tell me I will get this one PAID. Please. The bill is $620 for that consult! -rose-