Question:
Anyone get bcbs federal plan to pay for rny with 150 cm's bypassed?
This is what my surgeon wants to do and it is what I want done. — Kim N. (posted on January 10, 2003)
January 10, 2003
I couldn't read your profile, so I don't know where you live or anything,
but I live in Illinois. I had my surgery done at BTC in Belvidere, IL. I
had Blue Cross FEP at the time of my surgery. I had 150 cm bypassed and was
transected (sp?). My surgery was covered 100%. All I paid was $100 for the
copay. If you have any questions about BCBS FEP feel free to send me an
e-mail. Good luck and God Bless!
— nchaudoin
January 10, 2003
I think if you have the Federal plan then BCBS is required to offer weight
loss surgery. They won't give a predetermination but approve after the
surgery. Kind of a sneaky way to scare you away but most surgeons have
delt with them and handle it easily. One even told me it's one of the best
insurances around to have for WLS. Good luck.
— Carmen K.
January 10, 2003
Kim - Please contact me privately by e-mail to discuss your issue. I tried
to e-mail you but you do not have a profile or e-mail address. My e-mail
is [email protected]
— zoedogcbr
January 10, 2003
Mine did, but I think you should check your plan brochure as all BC/BS
plans are not the same.
— Lisa N M.
January 11, 2003
Lisa - I can almost guarantee that your plan covered your surgery because
they did not know you had 150cm bypassed. The procedure code that it seems
all surgeons are using indicates it's 100cm or less bypassed. Most
surgeons do not even seem to know that there is a length restriction on the
procedure code they are using. If your insurance had requested a copy of
the surgery report and if 150cm is indicated in there it is likely it would
not have been covered. The 100cm limit is not a BCBS dictate, although
they seem to enforce it more, but part of the HICFA procedure codes that
the medical industry is governed by.
— zoedogcbr
January 11, 2003
I have Fed BC/BS and also had 150cm's bypassed and had absolutely no
problems with the ins. Actually, I only had a 100 co-pay for the hospital
bill. Just make sure that your surgeon and hospital are on your preferred
provider list! Good luck and God Bless!
— Leah H.
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