Insurance requirements for GEHA (Government Health Employees Association)

Hi everyone,

I am on the road to getting the gastric sleeve surgery done at Johns Hopkins Bayview Medical Center in Baltimore.  I was wondering if anyone on this forum had any experience with getting the surgery done at Hopkins Bayview, and also if you have had GEHA (Government Employees Health Association, a part of United Healthcare) insurance.  I am interested to see not only what the experience has been like for people getting the sleeve at Hopkins, but I'd also like to hear from people who used GEHA insurance...was it hard to get approval and particularly how much your out of pocket costs were. 

My insurance covers 85% and 15% is out of pocket.  I need to do the 6 month diet/exercise requirement with my doctor (just finished month #3) and I also need to have a psych eval and nutritional assessment, both of which have been scheduled.  I'm worried about out of pocket costs and was thinking of switching to Federal Blue Cross Blue Shield when our open season comes up in November since I've read on these forums that they pay 100% of it but since I already started the process with GEHA, I don't know how switching will affect it.  Also, GEHA will only cover it if my BMI is 40 or over, or it could be 35-40 with an existing condition (diabetes, sleep apena, etc.).  My BMI is 39 and I do have mild sleep apnea but I don't know if mild sleep apena will be enough to qualify me.  Any advice with GEHA or hearing anyone's experience with Johns Hopkins Bayview would be greatly appreciated.

You'll probably qualify just fine with sleep apnea.  Don't count on others out here to set the standard of what you should expect to pay, because the insurance companies can customize policies.  I highly recommend just giving them a call directly, then call the surgeon's office and see what they typically charge and how much they want up front (they usually want close to expected copay before surgery)