Blue Cross Blue Shield Federal Employee Plan Denied My Gastric Sleeve Surgery
by Heather
In your section about Gastric Sleeve Surgery, it is mentioned that only two insurance companies have been known to cover it for folks in the past, one of which was the Blue Cross and Blue Shield Federal Employee Plan (FEP).
I was wondering if there is some more specific information on how this came to be known...as on many websites I was hearing stories that Federal BCBS covers the sleeve, but when I call them, they say they don't.
I sent this question directly to you (Bariatric Surgery Source), and you kindly responded to let me know that you made this determination by reviewing/considering the following resources:
1) CareFirst BCBS's web site (BCBS plan in the Mid-Atlantic) - see table on page 3
2) Bariatric Times article - see "Sleeve and the Insurance Industry" Section
3) Obesity Help patient forum
After further pursuing the matter with Federal BCBS, they have decided not to cover the sleeve for me. At one point in our many calls, one of the benefits people said that BCBSFed was going to be reviewing its policy on whether or not to cover the sleeve in April and should have a decision in May.
Since then we cannot get anyone to confirm this or repeat it. As much as I would prefer to have the gastric sleeve procedure, I have decided to move forward with gastric bypass surgery rather than wait until it is or is not approved.
I have submitted the bypass paperwork and do believe that it will be approved by Federal Blue Cross Blue Shield even without comorbidities.
Have a great day!
Heather
Submitted 4/5/2010
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