Question:
Am I understanding right that bcbs federal (iowa) doesn't cover rny with 150cm bypas

It is kind of driving me crazy that they don't preapprove. The nurse at the Dr's office hasn't said anything about this and she is on top of things. I know someone who had this surgery here at work with the same ins. had no problems. HELP    — Kim N. (posted on January 10, 2003)


January 10, 2003
I have federal BC/BS. It is my understanding that it is the same no matter what state you are in. They do not preapprove, but will cover WLS if you are 100+ lbs. overweight, BMI over 40. They pay 90%. They don't preapprove, which did kinda scare me until I talked to several people locally who had no problems getting stuff paid. (I am in Alabama btw). My BMI was 50.5 so there was no question I was qualified.
   — sheltie

January 10, 2003
I just had open RNY <100cm because my surgeon instructed me that BC/BS Fed. considers anything over 100 to be experimental. My BMI was right at 40. I took the chance and had no problems with them paying. I received my EOB 6 weeks after surgery and the total cost of my surgery (no complications) was 30K!
   — jengrz

January 10, 2003
You should read your pamphlet. I believe all federal BC/BS is the same and that they don't preapprove. You have to be 100 pounds overweight and they pay for gastric bypass or gastric stapling. It doesn't say anything about how much can be bypassed. Just make sure you don't get DS, Lap-Band or something like that.
   — Lisa N M.

January 11, 2003
I had 150 cm's bypassed and it was covered by Fed BC/BS. There was no problems at all.
   — Leah H.




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