Federal Employee Plans

Trin2rilax Cheryl
McCoy

on 11/9/04 3:32 am - Columbus, OH
Anyone have any experience in knowing which plan is best for federal employees. There are so many that I am confused. I have already had WLS but will be doing Plastics soon. I also want a good dental and eye plan. Cheryl
gary viscio
on 11/9/04 11:52 am - Oceanside, NY
RNY on 07/01/03 with
Most plans exclude plastics unless it is reconstructive and their are guidelines. When or if you decide to go for plastics check the plan and make sure that you meet their guidelines. Gary
C T.
on 11/12/04 9:47 am - HI
Hey Gary, I've got a quick question if you don't mind. I have BC/BS (HMSA)Federal Employee Program, which states "Adjustable gastric banding (CPT code 43843), whi*****ludes the Lap-Band procedure, is no longer considered investigational. However, the procedure is not covered by FEP as it is not a benefit of that plan." Now, this particular procedure IS covered through regular BC/BS (HMSA) and various other types of Gastric Bypass are covered as well under both policy guidelines. I haven't been officially turned down by the insurance company, but based on the above, it would have been a certainty. Any ideas regarding how to get around this? I realize there is an appreal process and external review board to go through, but am trying to find the most expedient method of accomplishing this. Thanks! Candy
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