fed bcbs approved same day

For all of you out there with Fed BCBS I just wanted to let you know I got same day approval. After jumping through hoops taking the psych evaluation and getting 5 years of weight history and diet lists they didn't ask for any of it. They didn't even ask for paperwork.  My surgeons office called and all they wanted to know was my height, my weight, my BMI, and my comorbidites and than they gave them  approval codes immediately.   I have to say that lately FED BCBS has been awesome, they've been paying my claims in under a week.    My surgery date is now scheduled for April 11, just around the corner,  so that gives me a whole new set of things to worry over. Good luck to everyone Josie

WTG! That is fantastic. You are going to do wonderfully....you did it!

Hi Babydog I hav BCBS FED Standard thru my DH....I am contemplating DS or VSG surgery and hope they approve which ever surgery I request to have. Thank you for posting regarding ur approval as I have been searching for folks recently approved by this insurance. Can u let me know ur BMI and height. I am 5'7 and bmi is 39. I want to know if I will have problems geting approved with no comorbids.() Once againg thanks for any info you can provide.  Good Luck On ur surgery!

Hi, I am 5 5 with a BMI of 41.  If you check out page 48 in the service book or go online to the fepbcbs website it says you need a BMI 35 or greater with  comorbidites or you can have a BMI of 40 or greater and not need any comorbidites.   Have you been weighed at your surgeons yet?  If so mine did not deduct anything for clothing or shoes so that added 2lbs. and your scale could be wrong compared to the DR.s  The difference of a BMI of 39 and 40 is only a few pounds. Also, I was always 5 51/2 I shrunk a 1/2 inch as I aged. You may have that BMI of 40 and not realize it.  Than you wouldn't have to worry about comorbidites. The service plan book does not specify which procedures are covered but I do know they cover lapband and RNY.  If you call them they'll be happy to tell you. Let me know how you made out,  Best of luck Josie

I also have BC/BS federal and I have the Basic plan - not Standard.  My co-worker signed up for Standard plan just this year so that she could have lap band surgery.  She previously had insurance thru her husband's employer - they didn't cover ANYTHING related to weight loss.   Since we work together and are having the same surgery with the same surgeon, same hospital, etc., we've been able to get a good comparison of the benefits of each plan.  So far, my Basic plan has far outweighed her Standard plan - I only pay co-pays where she has to pay a deductible and percentage.  I had to have an upper & lower scope (ie EGD and colonoscopy) and only had to pay $100 for the surgeon's fee.  I had to have a heart catheterization and the only bill I've gotten for that so far is $30 for a consult co-pay prior to the procedure.  These have both been outpatient procedures.  While my co-worker didn't have to get these pre-op tests done, the tests that she & I had that were the same are costing me a lot less out-of-pocket.  We're keeping our EOB's to compare at the end, but it seems that I'm coming out ahead of the game compared to the Standard plan.   On a side note - the reason she chose the Standard is because there are some benefits for out-of-network providers, whereas the Basic has NO benefits for out-of-network.  All the doctors that I've seen have been in-network providers (with the exception of the the one out-of-network mentioned below). I definitely agree that BC/BS has been great lately.  Did you guys do the health care flexible spending account?  I should have allotted more - I only put in $2500 and it's already spent!  (Long story there - I used out-of-network provider, so the FSA dispersed the billed amount to me when I only had to pay the co-pay and the out-of-network provider adjusted the bill to reflect in-network copays). If you have co-workers that are considering either surgery, tell them to weigh the benefits of the Standard vs. Basic plans.  It seems that my Basic is definitely costing a lot less than my co-worker's Standard plan.  And it's less per-payday also.

Hi, I have standard plan and have noticed that in alot of ways basic is cheaper.  The only thing you have to really watch out for are those out of network providers that can sneak in on you. For instance, my husband had an endoscopy and while the Dr. was covered his anthesiologist was not a participating provider, we didn't find that out until the day of the scope. Also,  my RNY surgeon is a provider but his surgical assistant isn't.  So if I had Basic I would have to pay the entire fee for the assistant. I guess they both have their pro's and con's. Best of luck Josie

I was reading in the benefit plan brochure that no additional payments are required (in Basic option) for the services of a surgeon's assistant.   I never thought to ask my surgeon about an assistant... I wonder if it's the Physician's Assistant that works in his office.  Is that usually the case?  I never thought about the PA being in the OR for surgery.  There's another guy that gets to see me naked and FAT!!

If I were you I would call the Dr.s office and find out.  While I'm certainly no expert I would think the odds are pretty good that they'll need an assistant.  There is a whole lot of stuff to hold and move out of the way no matter what procedure you have.  I would also find out who the anetheisologist is and make sure that they're in your plan.  You don't want to get stuck with that whopping bill!  And it's always when you're not prepared that it happens.   Do you have a date yet?

I have an appointment with the surgeon this morning to get a date.  Cross your fingers for me!  I hope it's soon.

I thought about you today!  How did you make out?  Do you have your date?