Question:
Does anyone here have Blue Cross Blue Shield Federal Employee Program?

I have my first appointment scheduled for June 20 with my surgeon. I called my insurance company today and found out they don't pre-approve the surgery. That means I would have to have the surgery and then find out if I'm covered for it. I don't have a lot of health problems besides the fact that I am 5'5" 265 lbs. So that means I can't have the surgery. I can't take the chance of getting build 20K or more. I never thought I wish I would be sick. But I do. I am soo depressed about this. KathyG    — Kathy G. (posted on April 26, 2002)

April 26, 2002
I have BC/BS Federal PPO also. And you are right they pre-certify but not approve. Which meens if after your surgery they dont pay, your Doctor is stuck with the bill not you. I had my RNY 9-19-2001 with no co-morbidities, but a BMI over 40 was all they needed to qualify me for the surgery. I am down 90 pounds in 7 months! I dont know why you feel you will not be aproved. E-mail me if you have any questions. I have only had to pay about $275.00 OF MY $26,000.00 bill.
   — nkoehler88

April 26, 2002
I am 3 weeks post ob and I have blue cross/ blue shild ppo federeal -- I am not sure if it is different state to state but they did pre-approve me and they paid for the surgery . I had to pay $100 only out of 39,000. I wish you much luck
   — sallie P.

April 26, 2002
I am also BCBS Federal and I was worried when they wouldn't preapprove but they said it's no problem as long as we meet the requirement of being 100lbs overweight. They paid for almost everything. You are actually very lucky to have this insurance because we don't have to fight for approval like so many others do. Good Luck!
   — Michelle F.

April 26, 2002
Hi, I had BC/BS Federal and had my surgery last July. Your weight and health sound exactly like mine, I didnt have a lot of co-mordities, but had knee pain, back pain, shortness of breath with exertion. They approved it and payed for it--no problem!!! I think you should be fine, you could ask your doctor's office if they have delt specifically with this insurance company covering this surgery recently. Good luck!!
   — Cory F.

April 27, 2002
Kathy, I have the same insurance and its one of the easiest for the surgeon to get the OK> I'm in Virginia and my surgeon submitted the letter to the insurance company, but went ahead and scheduled the surgery before he heard back from the insurance company. I got my approval/pre-cert letter about 2 weeks after surgery!! And I had no glaring co-morbidities, just 110 pounds overweight, history of other diet programs, hard to breathe and exercise due to the excess weight, and back pain, again from the excess weight.
   — Cindy R.

April 30, 2002
Hi. I have this same insurance and had no problems getting approved. My Dr. said it's one of the easiest. Just make sure you find Dr.'s and hospitals that are preferred providers. That will help to keep the cost way down. Good Luck to you.
   — Leah H.

April 19, 2003
4/19/03 Hi! Have you had your surgery yet? I have Fed BC/BS Standard Option and they said I did not need pre-approval, so went ahead the app'ts. Will have open RNY on 5/2/03 and I was just told last week by the doctor's secretary and my Blue Cross case manager that it was approved. Keep us posted. Kathy
   — Kathy M.