Federal BCBS Employee Basic Option California

Hello,

I am going through the qualification process for surgery. I fall below the 40 BMI. I am 38% BMI with only one comorbidity- mild sleep apnea. I am getting a work up on my back because I have retrolothesis.

Had anyone out there been approved with mild sleep apnea as your only comorbidity by this insurance, and were you requires to be morbidly obese for one year prior to the surgery?

I'm concerned that is the case and since I was just diagnosed with sleep apnea today I will have to wait a year...assuming mild sleep apnea even falls under their accept led category.

I'm so at a loss. I feel like I'm going through this process and will get denied. I don't want to get my hopes up.

Any feedback would be appreciated from folks with the same heath plan.

Thanks,

Pam

So my main advice is to call the number on the back of the insurance card and speak with someone who can go over eligibility requirements with you, as they will be able to tell you with much more certainty than we can how likely the surgery is to be covered. However, I do have BCBS Federal Employee Program Basic Option, and remember the requirements very well. It is required that you have medical documentation that categorizes you as morbidly obese over a minimum period of 2 years. This definition is having a BMI of 40 or above or a BMI of 35 or above with one (or more) comorbidities. So you would need some sort of documentation stating that you have had sleep apnea for the past 2 years. I don't know how or if that could work with you just being diagnosed today, but there it is.

Best of luck!