Open Season for Federal Govt Employees Insurance

cathya
on 11/17/15 4:52 am - Orlando, FL

Any Govt workers out there?  I'm trying to find out if anyone know which if any of the Insurance plans covers the reconstruction surgery (lower body lift) after WLS.  I looked at the OPM website since it is open season but it will take forever to go through each plan. I know about checking each plan, but that it very time consuming.   Just thought I'd ask if anyone has had theirs covered.  I have BCBS who say they will cover it if medically necessary - tough to get a Dr to sign off on that.

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Worry looks around, Sorry looks back, Faith looks UP...

Cathy Alphin
OH Certified Support Group Leader & Coach
Orlando, FL

emelar
on 11/17/15 2:16 pm - TX

I don't think any will cover a LBL.  BCBS FEP has covered some co-workers' tummy tucks as "medically necessary" but they had to produce a doctor's justification for it.

cathya
on 11/17/15 7:07 pm - Orlando, FL

Thanks Emelar, that was the kind of information I was hoping to find here.  Do you know your co-workers well enough to ask them what the justification was or if that makes you uncomfortable - would you ask them if they would correspond with me and "help a fellow WLS grad??" with BCBS.  If I had an idea what verbiage worked with BCBS, I could ask my Dr to write the same for me.  Thanks again for your help. 

emelar
on 11/17/15 7:31 pm - TX

I know with one it was documentation of rashes and skin break down.  She'd had a long history of it even before WLS.  I think it was similar with the other, although she didn't have the same long history.  Most of the time, I swear it's an issue of which caseworker at the insurance company you get assigned to!

cathya
on 11/17/15 7:48 pm - Orlando, FL

I think you are right about the case worker.  Well, wish me luck.  I'm going to try getting the paperwork done for BCBS.

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