Best insurance for federal employees???

[dragnfly 0]

I am trying to figure out which federal ee insurance provides coverage of lapband. I currently have BCBS, and they cover only gastric bypass. I plan on changing during the upcoming open season. Any ideas from other federal ees would be appreciated.

[DrHekier 0]

GEHA apparently now covers the Lap Band.

[dotofoz 0]

I have the above ins and they DO cover it.

check out the attached file (hope it attaches correctly). i've also been doing some research and it looksl like it will be MANDATORY to cover obesity surgery (didn't specify rny or lap) for ALL fehb plans.....

anthem lap band policy.pdf

[kesha23 0]

Dragnfly, I am not sure if you know this or not. We got dropped from mail-handlers which didn't hurt my feelings at all, but we got to choose a new insurance. BC/BS FEP just released their 2007 brochure with changes and updates. They have added gastric restrictive procedures (lapband) to the things that they cover starting January 2007.

[kristielynn 1]

Copied from:

Blue Cross® and Blue Shield®

Service Benefit Plan

http://www.fepblue.org

2007

Gastric restrictive procedures, gastric malabsorptive procedures, and combination

restrictive and malabsorptive procedures to treat morbid obesity –a condition in which an individual has a Body Mass Index (BMI) of 40 or more, or an individual

with a BMI of 35 or more with co-morbidities who has failed conservative treatment; eligible members must be age 18 or over.

Benefits are also available for diagnostic studies and a psychological

examination performed prior to the procedure to determine if the patient is a candidate for the procedure.

Does this sound like they are going to pay for Lap Band after January 2007.

[kesha23 0]

Hi Kristielynn, yes ma'am. I have spoken with customer service from FEP BC/BS several times with tons of ?'s over the past few weeks and, they are definitley covering the lapband beginning January 1st, 2007. Good luck to you.

[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.