goverment insursnce

[Guest jayla]

has any one ever had mail handler insurance? i work for the federal goverment.

[Sheila 0]

Hi Jayla,

I just received approval from Anthem Federal (Blue HMO). I live in Ohio and work for the federal government. I had called Mail Handlers in case I would have to change insurance companies, and they did tell me they covered the lapband, but what you're told and what actually happens isn't always the same thing! I just know for a fact that Anthem Federal approved me and I am thrilled! Surgery is scheduled for Jan. 19. This should be the best year for me in a looooong time.

Sheila

[Sheila 0]

One more thought: I understand that GEHA also covers the lapband procedure.

Sheila

[bronco 0]

As this is open season for Federal Employees, I have been considering which insurance to select in large part based on their willingness to do LapBand.

I currently have Mail Handlers and spoke with a nurse who sent me their checklist - they do cover this procedure. The difficulty she indicated is "documentating that the patient has failed to loose weight (10% from baseline) or has regained weight after participating in a 3 month physician supervised multi-discipinary program within the last 6 months" .

GEHA also covers this procedure but requires documenting failure to lower BMI after a 6 month medically supervised program of weight loss.

The point is that they (FEHB providors) are now covering this procedure but it will require navigating their process which can be daunting.

[dotofoz 0]

I'm 99.99999999% sure that it is MANDATORY for ALL FEHB plans to cover WLS. You have to watch which is covered AND what the requirements are.....Thanks for the BCBS Blue HMO Ohio info....I think mine's going to be submitted next week.....Send me GOOD vibes!

[debbiek1 0]

I'm 99.99999999% sure that it is MANDATORY for ALL FEHB plans to cover WLS. You have to watch which is covered AND what the requirements are.....Thanks for the BCBS Blue HMO Ohio info....I think mine's going to be submitted next week.....Send me GOOD vibes!

i also have bc/bs federal plan and i would like to know if they make you go on a supervised diet before they approve you.

[DiscoDiva 0]

Hi, I have BC/BS federal through my husband. I was not required to do anything, diet or otherwise. My daughter and I both were approved! Having it done on Feb 14th. Where in OH do you live. We live in Ohio also.

[debbiek1 0]

Discodiva-thanks that is good to know.

when i called BC/BS fed they just said i needed a recommendation from the surgeon. but the packet from the surgeons office wanted to know all "supervised "diets i have been on in the past 5 years, so i have been kind of fretting over whether i would have to go on a 6 month diet before i got this done. i havent been on any supervised ones. just the ones i have imposed on myself which usually last until noon everyday.

i live in columbus and i havent seen many people on the boards from around here. mostly dayton and cincinnati.

that is neat that you are scheduled on valentines day!!! the best present you can give yourself and your hubby--by next valentines day you will be able to wear the sexy red lingerie!!!!!

[DrHekier 0]

One more thought: I understand that GEHA also covers the lapband procedure.

Sheila

I think GEHA only covers the procedure if done at a facility which is certified as a Center of Excellence

[siniam21 0]

what about medicaid in ny

[sabrena 0]

I have federal bc/bs. I have PPO. I went to a seminar on Sat 2/3/2007and they submitted my paperwork to bc/bs on Monday 2/5/2007. Do I really have to go thru a supervised 6/12 month diet? What is the general out of pocket cost? And what general range is the timeline for bc/bs to give me an answer?

[debbiek1 0]

wow, things in texas sure move faster than they do in columbus ohio!!!

i went to the seminar on dec 15. after that it took a couple weeks to get the forms. then i had to schedule an appt with a psychologist. then i had to get an appt with a nutritionist. then i had to go to a support group meeting which only meets once a month and i missed january's so i just went this week. now i have to go to a 2 hour nutrition class.

hopefully, after this nutrition class i will have fulfilled all my obligations and i will hear from the surgeons office within in week and i can get scheduled in for my first appt there. once i actually SEE the surgeon then they will submit it to the insurance company.

the surgeons did want a list of all supervised diets i have been on in the last five years. i really havent been on any supervised diets. i dont think the BC/BS federal plan requires that. they told me they only need a predetermination from your surgeon that you need the surgery. but i still dont know for sure if this surgeon is going to make me go on one. maybe after this nutrition class tomorrow i will know more.

as far as the general out of pocket expense--bc/bs told me they would pay 90percent if i went to their preferred provider.

but perhaps Disco Diva can tell us more about that, since she is scheduled next week.