Shelleymb 75 Posted November 14, 2012 I was wondering if anyone has been covered or partially covered with Blue Cross Blue Shield for Lap Band and a federal employee. I am D.O.D. and group health doesn't cover it with my plan, but that is because my employer has denied it, but I was wondering if that is a:allowed and b: something that happens to many people. Any information would help! tia Share this post Link to post Share on other sites
suzannelturner 10 Posted November 14, 2012 I have bcbs federal option 104 and they covered almost all of it. I had to submit 3 years of weights, 4 months of pre op dr visits. They don't pay well on the fills, I have to pay $71/ $330 each time I get a fill, but it's not bad. I'm so happy I had it done & I'm so happy they paid! Share this post Link to post Share on other sites
suzannelturner 10 Posted November 14, 2012 I'm a DoDEA employee, so I'm also a DoD employee. Share this post Link to post Share on other sites
Shelleymb 75 Posted November 14, 2012 Thank you sooooo much. I'm calling tomorrow to make sure for my state and if its true I'm switching tomorrow!! You made my night!! Share this post Link to post Share on other sites
suzannelturner 10 Posted November 14, 2012 You're welcome! It's open season, so jump on it!! Good luck!!!!!! 1 Shelleymb reacted to this Share this post Link to post Share on other sites
Dulci 108 Posted November 15, 2012 I thought that all FEHB plans had to cover the same things. I had my surgery under Fed BCBS, Standard Option, but I switched to Mail Handler's this year. Both plans cover bariatrics. Share this post Link to post Share on other sites
Shelleymb 75 Posted November 16, 2012 I have bcbs federal option 104 and they covered almost all of it. I had to submit 3 years of weights, 4 months of pre op dr visits. They don't pay well on the fills, I have to pay $71/ $330 each time I get a fill, but it's not bad. I'm so happy I had it done & I'm so happy they paid! Do you have Standard or Basic plan? Share this post Link to post Share on other sites
suzannelturner 10 Posted November 16, 2012 Standard option plan 104 Share this post Link to post Share on other sites
Shelleymb 75 Posted November 16, 2012 Ok, thanks. I'm just so confused. About how much did you pay for the surgery it's self, with the copay? Share this post Link to post Share on other sites
suzannelturner 10 Posted November 16, 2012 Ok' date=' thanks. I'm just so confused. About how much did you pay for the surgery it's self, with the copay?[/quote'] I paid $258 to my dr and $2k for the hospital bill. Sounds like a lot, but the hospital bill was $16,500!!!! I'm okay with only paying $2k!! 1 Shelleymb reacted to this Share this post Link to post Share on other sites
angels5998 4 Posted November 16, 2012 I have the federal BCBS and I hardly paid anything. Just a surgeon copay of $75. Fills for the first two years post op are free also. I did have to pay a copay on office visits prior to surgery. My husband just had it done in oct and same for him too. Share this post Link to post Share on other sites
Daddyof4 95 Posted November 16, 2012 I am with the Patent and Trademark Office (Alexandria, VA) and have Blue Cross Blue Shield standard option plan 105. My out of pocket was similar to Suzanne's and they included 3 months of followup visits with no copay. I paid $25 of the $250 for my last fill. The required 3 months of supervised diet and nutrition counseling and a psych evaluation - I think they want to pay for those who are likely to succeed and the extended pre-op regimen helps determine that. It seems like not all plans pay the same so make sure you talk to someone at your local BCBS. The more specific your questions are the better the answers will be. Shelley, I wish you great good luck and hope you can get banded. It is the best thing I've ever done for myself. Share this post Link to post Share on other sites
suzannelturner 10 Posted November 16, 2012 I also had 3 months of free follow ups. And now I have to pay $71. Not bad though! Small price to pay for saving my life!!!!! 1 Shelleymb reacted to this Share this post Link to post Share on other sites