Question:
what are the requirements for wls having fep blue?

I need to know the requirements for fep blue insurance. Such as consecutive office visits, documented diet history...My daughter will have fep blue in Jan.2003, and is in the process of researching wls. Thankyou in advance    — wizz46 (posted on December 17, 2002)

December 17, 2002
Medical necessity, diet history, per-certification. Depends if it is standard or the new one(not sure what it is called) on the percentage of coverage. I also found out they will cover the RNY surgery, but not the laproscopic (sp. Be sure she finds a PPO hospital and doctors. I decided not to go with them during open season because the hospital and doctors I have chosen prefer doing the lap. I prefer this too. Hope this helps some. Happy Holidays!
   — babrewer

December 17, 2002
I had surgery 9/16/02 with FEP blue. The qualifications for medical neccessity are that you are 100 pounds overweight and are over the age of 18. They DO NOT precertify for the surgery. However, call a customer service representative and they will explain that if you meet those two qualifications, your surgery will be paid for. Make sure you find an in network surgeon and hospital. I just finally got my bill the other day. The total cost of the surgery was around 46,000, but I only paid $100. I think it is an awesome insurance. If you need any help, let me know. Good luck and God Bless.
   — nchaudoin

December 18, 2002
I too have BC/BS Federal and my insurance did approve for Lap RYN. My surgeon specializes in Lap surgery and only does open in the event that he can't get to your organs properly. And we have talked from the beginning due to the physical demands of my job (underground coal mine inspector) that the Lap would have less chance of getting hernia's after surgery.....doesn't mean it can't happen, but chances of hernia's are greater with open incision.
   — Sissy I.