Question:
Has anyone recently dealt with BC/BS Federal?

I am a bit confused with this. I went to a WLS seminar and was told that with my insurance, there were no requirements that needed to be met prior to surgery. Reading over the paperwork they gave me, I saw a sample letter that the physician needed to forward to the bariatric surgeon regarding my weight history. I called my insurance and was referred to a link on their website and it stated that to even be considered for surgery that two criteria needed to be met: 1) diagnosis of morbid obesity and 2) evidence that comprehensive non-surgical treatment has been attempted prior to surgical treatment of morbid obesity. So I am assuming there are requirements I need to meet? I have tried getting information from my doctor but had no such luck.    — jaelyn0613 (posted on September 6, 2009)

September 6, 2009
Hi Laura, My Dr gave me a checklist of things needed prior to surgery and included was a letter from my primary Dr and for diagnosis - I don't remember who wrote it up whether it was my primary or WL surgeon. The packets given to you from the WL surgeons are pretty informational for insurance and ourselves. I had no problem getting approved. Rosemari
   — hlogic1

September 6, 2009
I had RNY August of 08. I had no issues with BCBs Fed Plan at all. I made sure that I filled out the questionaire that I was give with every diet I had every tried from atkins to jenny craig to south beach etc. After I did that I didn't even need a letter from my PCP or a referal. I found a surgen that I liked and made my plans from there. Do you have the PPO?
   — phyllismmay

September 6, 2009
Hi. Just make sure you have a surgery that is covered by your plan. I was denied and now owe huge amount of money to the surgeon, hospital and anesthesiologist because I had the VSG, which is neither restrictive nor malabsorptive. BCBS FEP does not do preapprovals. You go ahead with the surgery and hope to God that it is covered. It is a very lousy way to do things.
   — cydthekid50

September 7, 2009
Hello, I just had my surgery three weeks ago and I have federal BC/BS. All they required was that I either had a BMI of 35 with a co-morbidity or a BMI of 40 or greater. Do you have the standard or basic plan? There may be some differences between the two.
   — kaylazoe

September 7, 2009
Yes, I had surgery with BC/BS Federal. Although my diet history was spotty and incomplete, I had no problem at all getting approval. My BMI + at least 3 co-morbidities insured the diagnosis of morbid obesity. I was fortunate that my bariatric doctor's office, Life Without Limits, in Muskegon, handled all the filing of insurance papers for me after I had filled them out completely. BC/BS Federal was very easy to work with and didn't require extra "hoop to jump through".
   — Marilyn Schurman