BCBS Fed Questions

Hi I can't help you as I am opting for the lap-band, and just starting to get everything together, I see the surgeon next Monday for the 1st time, BUT because we seem to have gotten a few of us together on the forum, who have FEPBLUE - I wonder if anyone is in Fla- as they seem to say the state you live in makes a difference- NOT sure of that's true for FEDS,
I am concerned with the 30% out of pocket -as well as all the requirements for the 3 months, of supervised weight loss, blah blah- just would love to know who already has passed the 1st part of the journey, and would like to share. I would like  to know what my exepenses might be if possible.
As for your question, I understand it is up to what the employer agrees to and I did see that type of surgery on pg 53 of the 2011 benefits manual. I I know that talking to a REP can be painful as they just read out of the booklet, which we can do ourselves, that's why these FORUMS are so important!

I have Fed BCBS (administered by Carefirst in the DC area) and had a terrible time with them. First they denied the sleeve saying it wasn't the standard of care for someone with a BMI under 50. I appealed that (check my blog). Then they denied me a second time for totally different reasons: my co-morbidities weren't serious enough to qualify me with my BMI of 35. I got a sleep apnea diagnosis and appealed to OPM and also had the doctor re-send the request for coverage in to BCBS directly with the new diagnosis. FINALLY, about two weeks before I was going to self-pay, they agreed to cover it. The regional administrators matter a lot; some folks with the exact same policy on here have no trouble getting coverage. Others, like me, had to fight tooth and nail. The whole process was about 9 months from my first doctor appointment to surgery. It was very stressful but I'm totally proud of myself that I stood up to the man and won! Coverage saved me at least $17,000.