Question:
Does anyone know what BC /BS Federal requires for tummy tuck to be considered

medically necessary? Also, is there anyone that has gotten approval for any reconstructive/plastic surgeries through BC/BS Federal? Did you have to pay up front due to BC/BS Federal not precertifying? Thanks for your help.    — Connie B. (posted on February 6, 2003)

February 5, 2003
I don't know what the approval criteria is, but I just wanted to tell everyone with Federal BC/BC insurance do not give up on being approved for reconstructive surgery. I went for a consult on 1/17/03 with Dr. Rast in Kansas City and with Dr. Ferris in Wichita on 1/24. I decided to go with Dr. Rast. It took them till the middle of last week to submit it to the insurance. Tues morning (2/4/03)I received a phone call from Dr. Rast's office--they have received a verbal approval from the insurance for my breasts, stomach and knees. My arms were not approved. I am so excited. I had prepared my own pictures and letter and just mailed them Monday to the insurance. They must not have even needed them. I have not heard from anyone who has been approved with this insurance, although I have talked to several who were denied. Don't give up!! They said I should receive my approval letter within a week and then we'll talk about the date.
   — jan M.

February 5, 2003
What is BC/BS Federal Insurance?
   — Christine H.

February 6, 2003
I am thinking that federal BC/BS plans differ in their policies. My claims go through the Washington, DC office and they will not preapprove anything. They told me you have to submit and then they make a determination. I had a breast lift & tt on December 11th and they paid for the breast lift (go figure), but denied the tt as cosmetic. Part of the problem, I was told is the way the doctor's office submitted the claim. I filed an appeal and I am waiting on a decision. Based on the information I received from customer service, I am trying to remain optimistic. I had a hernia at the same time and they believe if I tied all of that in with the weight loss that it will more than likely be approved. Good luck to you!
   — Lisa N M.