Question:
Has anyone had a problem getting BCBS Federal Employees Program to pay for surgery?
I called them and they do not do Precertifications. I have to have surgery first then they decide if they want to pay after surgery. — Debra P. (posted on May 28, 2002)
May 27, 2002
No trouble at all. They paid for my VBG and my
Extended Abdominoplasty.
— Cathy J.
May 28, 2002
My BC/BS (FEP) took a long time, but they paid for surgery I had last
December. It is my understanding that under this year's standard option,
the surgery is specifically listed as eligible. Check with your local plan
on www.fepblue.org.
Mary Nettleman
— Mary N.
May 28, 2002
Debra, check your plan, but usually if the doc says its medically necessary
and you have a history of other diet programs that have failed, BC/BS is
fine with it. I had the federal program too and they paid for
mine-approval was in less than 2 weeks.
— Cindy R.
May 28, 2002
I also have BC/BS Fed. and they pretty much paid for everything. My Dr.
said they are one of the best insurances to have for this surgery. One
tip...if you have a PPO...Make sure your Dr.and the hospital is on your
preferred provider list. Mine were and all I had to pay was the co-pay's.
Good Luck!
— Leah H.
June 28, 2002
I got approval yesterday, I went to the Doctor on June 14 and I think the
person that does the insurance at the office was off for a week so I was
really surprised that it happened so fast. This Doctor is an out of
Network Provider, so I have to pay 25%. The Doctor's office said I could
pay it out. But I am thrilled my Surgery Date is August 21!
— keissler
January 27, 2003
yes i had problems with federal bc/bs 2 years ago they did not want to pay
for the surgery until i had the surgery and then they would approve it to
see if i really need it was it medically necessary.
i could afford that rise and doctor could not afford that rise either so
that held me off from getting the surgery for 2 years
— pam J.
January 27, 2003
I have federal blue cross/blue shield. You should check your benefits
book. It says it pays for gastric bypass or gastric stapling if the
patient is 100 pounds overweight. They will not preapprove the surgery and
they don't ask for any comorbids. Mine wasn't preapproved, but they paid
afterwards. If you have basic you have to use a preferred provider. You
probably should anyway as you it will be cheaper when it comes to copays.
If you use a preferred provider who has done a lot of these surgeries, he
should be familiar with there no-preapproval policy. Good luck!
— Lisa N M.
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