Question:
How do you get federal bc/bs of Alabama to pay

Has anyone recently dealt with Federal BC/BS of Alabama for lap gastric bypass surgery? I have been trying to find out way to get them to pay. Of course, they do not pre-approve but, what is the best way to make sure you meet all of the their requirments? My BMI is 44, i do not have much co-morbities, i have a letter of reference from my primary care doctor. My doctors office called and said that the insurances only "requirement" is that your 100 lbs over weight and that you are 18 or older. what the heck is that susposed to mean??!! Please if anyone has any guidence with this insurance, PLEASE let me know. Thanks    — cmontoya324 (posted on March 21, 2003)

March 21, 2003
Best bet is to read your insurance plan and contact your insurer directly to find out their requirements.
   — Kasey

March 21, 2003
I have Federal BCBS of Kansas and I was approved for open RNY very quickly last year --I was precertified. I also have been precertified for abdominoplasty, brachioplasty, breast reduction and some work on my knees. Most of this was quickly approved--the arms I had to ask for a review. Good luck.
   — jan M.

March 21, 2003
I have the same insurance and it was scary that they did not pre-approve. My BMI was EXACTLY 40 and I had depression, stress incontinence, knee pain and a family history of diabetes and heart problems. I took a chance and they paid - no problem. They WILL NOT, however, pay for a duodenal switch as they consider it experimental. I had a proximal (100cm) open RNY.
   — jengrz

March 22, 2003
I have federal bc/bs and I am in Alabama. I had no problems getting anything paid for, even my second surgery due to complications and 10 day hospital stay. They did only cover 90 percent when I had mine done (May 2001) so I ended up paying a total of about $800 for copays etc. I have only found one person to have trouble with federal bc and she had a bmi of around 35 and was only 75-80 lbs. overweight..she had tons of comorbids and is appealing but was willing to self pay. Other than that I have not ever heard of them not paying. I talked to many people with my insurance before my surgery because I was scared that they didn't preapprove. I had a starting BMI of 50 and 150 lbs. overweight so I knew I would qualify.
   — sheltie

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