Federal BCBS (surgery in IL)

Hello all,

I've been lurking for a while now trying to find someone with insurance similar to mine. I've fond several federal employees but none that actually live in IL; but I'm open to advice from anyone. I was just wondering if anyone had any trouble with getting approval from FEP BCBS.I  ask b/c there is a LOT of confusion about the 6 month pre-op diet for federal employees in IL. The brochure as well as the people at the ins co states that the diet is not required but the insurance coordinator at the surgeon's office said that the rep she spoke with told her to look at the guidelines for BCBS of IL for the requirements. I had also been told that until I told the rep that I am a federal employee and it's not the same as the state plan. (FYI when you look at all the other health ins brochures like Aetna and GEHA it specifically states that a pre-op diet is required,BC does not have that listed). She finally asked a supervisor who informed her that I was correct and they were only looking for BMI and co-morbids. But I'm still a bit nervous b/c my surgeon's office was given wrong info. And it's funny too b/c when I met the surgeon and he asked about my insurance he perked up when I told him I had federal BC; he said that they are the easiest to get approved and only require the BMI and comorbids. By the way my BMI is 41 and I have diabetes and high cholesterol as well as chronic back pain which I'm in PT for and PCOS.

I have experience with this as I used to work for a major insurance company in the UM/precert department. I'm familiar with the entire process but not as a federal employee with BCBS. My info was submitted on Wednesday morning and we're waiting to hear back (it's for lap RNY). If anyone out there is a federal employee I could use some of their personal experiences for comfort.

Thanks in advance!!!!!

Daisy

Hi,

I am a federal employee who had a roux. I had no problem getting through the process. My doctor had seen a lot of people from where I work. I did the online psych evaluation and I had the surgery about 3 weeks later. I didn't have to prove any history of dieting or anything. It cost me about $300 since I already had met my deductable for the year. The process was simple. Just call the doctor of yopur choice and they'll fix you up! It isn't easy but it works and is the best thing I've done to date!

Thanks,

Stalwart