Insurance/Surgery Schedule Blue Cross Blue Sheild Federal Insurance approval

[sunny2day 50]

I have blue cross blue shield federal insurance and I am required to do a three month weight loss plan with a physician and a psychiatric evaluation. After I have completed all of this and the doctor submits the paperwork to the insurance for approval and the insurance approves it, how long can I wait after approval to schedule surgery without having to redo all of the requirements.

[notmeanymore 629]

I also have BCBS Federal and after completing all of my requirements I was approved within a week and a half. I was actually approved sooner but my surgeons office was busy and didnt call me for a few days. From what Ive read on here, BCBS approves very fast. I hope it comes quick. I cried tears of joy when I got my approval

[sunny2day 50]

It looks like if I am approved it will be right before or after Thanksgiving and I am trying to figure out if I waited until after the new year to schedule surgery if that would be too long after approval causing me to have to repeat all of the required preliminary steps.

[1gorgeousgodzilla 192]

I would think you should be good for a couple of months. Most people want their surgery done YESTERDAY, but my surgeon had some that wanted to wait a couple of months due to school, vacations, ect. I would think waiting til January would be pushing it, but why not err on the side of caution,call BCBS, and ask?

[MuttLover 15]

My advice -- just do it. Your benefits change on January 1 -- so if you have deductible, etc, that starts over. If you have a medical FSA and planned to spend your copays, etc. from the FSA, that starts over.

If you are not mentally ready to have your surgery after you complete your requirements, then wait to start your requirements. There will always be reasons to put this off -- if you are committed to making these changes for yourself -- go for it.

I had my surgery exactly one week before Thanksgiving -- and traveled to NC from MD three days after I got out of the hospital (5 days after surgery) -- we did stop every hour to walk around (wanted to avoid blood clots!).

This surgery is a big commitment -- and if you aren't ready to make that commitment, it's better to postpone it until you are certain that you can make the lifestyle changes necessary for success. And if you are ready to make that commitment, then putting your health needs first in order to achieve your goals is something that you'll have to figure out. It's not easy, so giving it some serious consideration now, and developing a plan is critical.

The holidays are not that hard -- if you don't want to tell people about the surgery, you can just say that you are just getting over some "stomach thing".

Maybe make a list of the pros and cons of putting off surgery, and see if that list help clarify. Or ask the group for some possible solutions to cope with your cons.

You have to do what's going to work best for you, and at a time that you feel you can put your best effort forth! Best of luck on your journey!

[notmeanymore 629]

Im with MuttLover, you dont know if your insurance will have drastic changes after the first of the year. There is no time like the present to get it done. A lot of surgeons do take holiday time off so I say get it done as soon as you can.

[sunny2day 50]

My dilemma is I did not realize when I started the preliminary steps that it would put me at possibly being approved during the holidays. My senority where I work is at the bottom. If I choose to go ahead and have the surgery during the holidays then someone else in my office will have to forfeit their holiday plans and work for me. I also have small children in daycare and if I do it during the holidays they will be home during the day while their daycare centers are closed.(I would like them to be at daycare during the day so I can focus on recovery) I am trying to not impact any one else's holiday plans at work and schedule my surgery after the holidays if possible. I have blue cross blue shield federal Basic plan and I will not be loosing any benefits by waiting. I called the insurance and for blue cross blue shield basic they said the approval is good for 6 consecutive months after approval. Thank you so much for all of your feedback. This forum is so great.

[Fit2btied 122]

There is Always going to be an excuse not to do it. I have 4 children all in travel sports and could use them as one every time. If you feel that the surgery is going to change your life for the better, then take the leap. But it sounds like you want people to say wait. So if there really is all that conflict and you know your insurance is going to cover it come the new year, then by all means wait. But what if you really do want the surgery and wait for all the other little things to work out and your insurance changes and you will no longer have the surgery covered?

That to me would be worse case scenario.

[MuttLover 15]

Here's what I'd look at:

1. What kind of job do you have? If it's a desk job, you can probably be out of work two weeks, and be fine ( a little fuzzy, but fine).

2. How long would you be out for the holidays anyway (and is your office so busy that you MUST work?). I overlapped the holidays in order to minimize the time out, and "questions" -- so I could say that I went to visit our son in NC -- and not have to answer questions about why I was out.

3. Who is going to be home with the kids during the holiday? If you are going to be home "anyway" or can get some help at home -- and your kids are old enough that they don't have to be picked up, then that still might work out -- but ONLY if you plan to be home for the first two or three days while they are still in preschool!

4. If you have plenty of leave time, etc. -- I'd definitely recommend waiting until you know you can be alone during the day, and not have to worry about the kids.

5. If you are going to wait until the beginning of the year, I'd definitely put all of the money for my copays, etc. in to an FSA. I have Basic as well, and while things went very well for me, I did end up having some additional tests, etc -- so I blew through my FSA faster than expected.

6. Do you have access to the EAP (Employee Assistance Program) -- I had my psych eval done for free by an EAP counselor.

7. While the approval is good for six months, your deductibles start over -- so try to determine what your out of pocket expenses would be now vs. 2014 to see if there is a significant difference. The 2014 book isn't out yet, so I don't know if the deductible changes.

Best of luck -- I was very lucky, in that I had no post-op problems at all except nausea (which was completely expected because of my history). So my approach was to hope for the best, but prepare for the worst! So make sure that you have child care lined up in case you feel worse than you expected, etc.

Take care!

[1gorgeousgodzilla 192]

Here's what I'd look at:

6. Do you have access to the EAP (Employee Assistance Program) -- I had my psych eval done for free by an EAP counselor.

!

Oh why didn't I know about this??? It is a brilliant suggestion.

[sunny2day 50]

Thank you so much Muttlover those points are so right on topic. Last year I went to have a tubal and ended up with a severe abdominal infection that literally almost killed me. I was hospitalized for two months. This was not planned. My husband has a job that does not care if you are sick or even hospitalized, in Texas it is an at will employer state. They don't have to have a reason to fire you. I have a 3 year old that climbs on me all the time. With my office job we have to have a certain level of staff available everyday we are open because we work with the public. I am one of two required people to be available for all of November and December. Most of my office takes off during this time. I would hate to take two weeks off and someone else have to work. I have absolutely no family except what was my husbands. My mother in law who would help me when needed passed away about a year ago, so I am trying to plan for worst case scenario so my husband and children are not burdened and my coworkers are not burdened again. I really appreciate all of the comments. I am very ready for this surgery. I was actually going to try and do it last year but because of the seriouseness of my infection after my tubal the surgeon suggested I allow my body a whole year to wait, that's why I had to put it off. I am very committed to success from this tool. Luckily I do not have a deductible with my insurance plan, just a $150.00 surgeon copay and $150.00 hospital copay for each night I spend in the hospital up to 5 nights. I cant wait until I can have the surgery but since this is a elected surgery I am trying to be considerate and balance mine and my family and coworkers needs also since its the holidays.

[gomekast 559]

Different branches of BCBS have different rules. My dr office told me yesterday that most approvals are valid for either 6 or 12 months.

Call up your ins and ask them. They will be able to answer that, it's usually in the notes of the approval when it was given.

[cranberryridge 15]

My info was submitted today 10/10/13 to the federal BCBS basic plan. The WLS staff told me it would take 3-4 weeks for decision, My info was sent to BCBS in KY. Anyone have any idea how long it really takes? thanks

[cranberryridge 15]

Told to insurance today. They received my paperwork yesterday. The rep said turn around time is 15 days but normally less than that!

[scamperia 3]

I have federal bcbs and found out today I was approved. Took 1 day!! Surgery scheduled for November 18th!!