Besides the BMI requirement I also have the out of network obstacle.
CONGRATS on your referral!!! It's AWESOME that a RNY surgeon suggested the DS and wrote a recomendation for it! I think that's unheard of.

I posted this on the VSG forum.   But thought this would also be helpful to put on the insurance forum.

Hello VSGers...

If you are a Fed employee it is open enrollment time.

Well I currently have FEP BCBS and began my process in August to consider surgery for early 2011.  Well since it is open enrollment, I wanted to review the changes to the plan (of course I am mainly interested in the changes regarding WLS and some others).

Well there are some changes, mainly they are  requiring a 3-month  participation in a medically supervised weight loss program, including nutritional counseling begining in January 2011

So those that are looking to have surgery early next year, please be advised of the new requirements.  They can be found on page 53 of the Blue Cross Blue Shield Services Benefit Plan. Go to your HR office or find it on-line at www.fepblue.org.


Just thought I would share...
If you have additional information please share with other FEB BCBS VSGers.

Have a good day!

The fact that your PCP has provided a referral is a good thing -- that means the PCP supports the idea.   

The surgeon will need to submit for final approval from the insurance company and most likely will need to obtain some history from your PCP.

Good luck.....

Thank you! I went to obesity law last week and filled out their form based on seeing another post of yours :)  I got an auto reply and will try calling them this week... I'm happy to hear that they worked for you.

I am sending you lots of light for your usrgery next week

I have never heard of them. For my appeal I used the Lindstroms and they were great. They helped me get approved for lap band removal to DS revision. They also have very reasonable rates and specialize in weight loss surgery insurance problems. Their website is www.obesitylaw.com. Good luck!