Anyone have Blue Cross Blue Shield Federal PPO

Hello I just went for my consult for a TT on last Thursday...I am hoping that my insurance will cover it has anyone had any experience with Blue Cross Blue Shield Federal PPO I have the high option.  The drs secretary said that I have a good chance because I also had a hernia repaired when I had my lapband placed....I really hope they cover it thanks in advance for your help or advice.

I hope you have better luck with them than I have as we have just filed an appeal today.  They denied my panni surgery recently even though I have seen 3 surgeons who say it's really necessary.  We have the PPO, but the basic option, by the way.
  I was really surprised by the denial because they approved my RNY quickly.  My suggestion would be to call them and find out exactly what their requirements are.  I had planned to do this but the first PS I went to filed for approval with them before I was even ready and didn't have my documentation together.  According to their denial letter, they wanted more proof that I had unresolved rashes for more than 3 months, had problems walking or that the panni effected my every day life, and that my weight had been stable at least 6 months.  Oh, and that my BMI was less than 30.   This was just my requirements now, but may be different for you.
  Wishing you good luck!
                                                        Bonnie

Hi, I have BCBS of New Jersey PPO.  I was approved for the tummy tuck on the first go round; they did deny the breast lift because I didn't submit two letters from my dermatologist and primary doctor. The only thing that were sumbitted was pictures the surgeon had taken at his office.  So, take it from me, anything is possible.  I was told BCBS never pays for tummy tuck without making you jump through hoops; that's not true because they paid for mine.

Good Luck!

Sherline

Thank both of you ladies for your help I will let you know how things turn out for me....

I have BCBS federal  High/standard.  Look forward to what you find out.  Someone had mentioned to me the 6 month weight stable issue.  I don't anticipate them covering mine as I have no rashes under the panni.  I had a problem with rashes under panni and breast last summer; however, it hasn't been that warm this summer.  Am going to start getting estimates now.  Would like to get them to cover at least the panni  in case of any complications.

Good luck and please keep me posted.

Thanks

LinR

I have BCBS Federal PPO, Basic Option.  They have approved me for a breast tissue removal (for gynocomastia) and a removal of abdominal tissue/panniculectomy (deemed medically neccessary).

They approved ,me based on the surgeons medical necessity letter request alone, with no further inquiries or conditions.  I am one year (give or take) post-op from having the DS.  I am a 5' 10" male and weigh about 210 as of today, so I am getting close to goal weight.  Based on my actual body size, I believe I am very close to goal, as I believe after surgery I will be in a size Large shirt, and should be a 34-36 inch waist.

There are no weight or time constraints put on me by either insurance or the surgeon.  The approval was received by me about 10-14 days after the consult.  The surgeon told me at consult the he would dictate the letter that day.

And surgery is Thurs Oct 1.

Hope this helps some of my federal associates.

Understand BCBS is better than other insurance for approvals with medical documents neccessities.    

I have a hernia and need a body lift due to have rashes.   Just had my 1st doctor consult today.    Dr wants PCP/OBGYN documentations with my issues as well as my bariatric doctor.     I will turn it over the plastic surgeon for BCBS approval


I am BCBS Federal   Anthiem of Richmond.