FepBlue Plastics

Anyone ever have plastic surgery covered under BCBS Federal? I am just thinking ahead. I have a family so it will be hard to save a ton of money, so if my insurance company can help me out that would be great! But we all know how insurance companies can be a pain in the rear.

You would have to meet a certain criteria to have plastic surgery.  Your also thinking ahead and in the mean time as with every open season FEP policies change so its hard to determine what coverage may be for a federal employee a few years out.   Requirements usally included but not limited to Panniculectomy is considered medically necessary for the individual who meets the following criteria:  Hope this helps you a little to understand about plastics

1. The panniculus hangs below the level of the pubis (which is documented in photographs); AND
2. The individual has had significant weight loss of 100 pounds or more, as well as the following:
   • the individual has maintained a stable weight for at least six months AND
   • if the individual has had bariatric surgery, he/she is at least 18 months post operative; AND
3. One of the following:
   • there are recurrent or chronic rashes, infections, cellulitis, or non-healing ulcers, that do not respond to conventional treatment for a period of 3 months; information must be documented in office visit records; OR
   • there is difficulty with ambulation and interference with the activities of daily living; information must be documented in office visit records.

Panniculectomy is considered medically necessary as an adjunct to a medically necessary surgery when needed for exposure in extraordinary cir****tances.

Thanks for the info. I work at a medical insurance company so I get the ins and out of it and understand that it has to be considered medically necessary. I just wanted to hear from people who were actually approved by my insurance company. Thanks :-D

Well I use to approve and deny  I worked for the Federal Employee Program for 15 years and worked closely with the Directors Office and the OPM  so I know that is the criteria and I have seen them approved in fact I have approved some in the past

I just wanted to know it was a possibility. I know there are some companies that won't cover it in any way shape or form...sore, rashes, whatever. It's just comforting to know that after I have surgery and get healthy and lose weight that removing excess skin won't be terribly painful and I don't mean physically LOL. Thanks again. 

I had a whole topic on here about plastic surgery, i'll try to find it and restick it