Open Season Options for Federal Employees Health Benefits Program (FEHB)

[Lumpy 18]

i have Mamsi MDIPA and they were pretty easy to get approval. check them out

[Lumpy 18]

i have mamsi mdipa and was recently approved. looking back on it, it really wasn't that hard, just time comsuming.

i got a basic form form the nurse when i went for a consultation. the form just has 3 spots on it for your dr to complete. your name, age, weight, height, etc. you have to make sure you go to the doctor about the same time each month for 6 months consecitively. you can also have receipts from weight watches that you weighted in every month for 6 months or if you tried two different plans you can have 3 months form jennie craig and 3 months from weight watchers, for ex. i thought they would give me a run around but they didn't. because i really didn't know what they needed, becuase no one really new, it took a few more months. i had to pay 20 for speclst visit, and 100 for hospital, thats all. good luck, write back

[Pepper10 0]

I was banded in October 2007, My insurance is BCBS PPO Federal (Houston, TX). If I were you I would go with BCBS PPO, however, be aware that they will only cover the insurance with 2 Co-morbids..... (high blood pressure, sleep Ap, high colesterol, diabetes etc...) No insurance is a gurantee for every patient. Every patient is different.

I have type II diabetes and high blood pressure. Since I have a documented history of the co-morbids above and I have been taking meds for them, the insurance approved my insurance within 2 weeks.

[ras141414 0]

i just signed up FOR BCBS PPO.. I self paid for my band in TJ.. but I wanted maintennace insurance so I took out this PPO...I have already had 1 slip, which I paid for due to the fact the TRICARE WEST does not COVER LAP BAND procedures..

I am glad for open season and being a Fed Employee...

Diane in San Diego

[snowbird 2]

I have FEP BCBS standard and had my lap band surgery in Mexico. I had to pay the $8000 for surgery up front, but I just got a check from BCBS for $7926.00. It took them about 6 or 7 weeks to pay.

I think it helped that I got all my ducks in a row before submitting my claim. I went to my PCP and discussed the surgery, and he wrote up notes on the visit which discussed my co-morbidities, showed my BMI of 35, and noted that LBS would improve my health and help deal with the co-morbidities. By the way, they were not severe: elevated blood pressure of 155/40, slightly elevated sugar levels, joint pain in my knees due to congenital problem with my kneecaps, acid reflux. Nothing life-threatening at this point.

Since my doctor was concerned about the acid reflux, I had an upper g.i. endoscopy done which showed I had Barrett's esophagus and a hiatal hernia.

I then scheduled an appointment with a psychologist who did an evaluation and wrote that I was a good candidate for surgery.

Finally I got surgical report from my Mexican surgeon's office as well as an itemized bill, along with a receipt showing I had paid it.

I sent in all of this information with the form you can print out online for overseas medical treatment. BCBS never contacted my for any further information, and I now have my payment. Yay!

[marie 0]

My husband works at the post office so we have federal health insurance as well. I had to change insurance before I could get my band. We switched to First Care (from BCBS) they covered all of it. I only paid 150.00 for the whole thing. By the time I changed insurance and jumped through all the hoops it took about a year but it was worth it. I had my surgery last may and have lost 74 so far.

[shadst83 0]

It's almost open season again, and I don't want to make another mistake switching insurances to something I think will cover lap band, but doesn't. I can't seem to get a straight answer from my current insurance, Mail Handlers Benefit Plan (MHBP), though others have told me that they are great only for bypass. I have firmly decided on lap band.

Does anyone with Federal experience have any suggestions on switching health plans within the government plans offerred. I only plan to look at the national plans, but, in case it makes a difference, I live in Houston, TX.:help:

Hi Guinness ... BCBS fep standard here. I had my surgery in November and still haven't gotten my EOB from the procedure. However, all associated medical expenses have been paid (including for my first fill), so I'm optimistic that my surgery will be covered. It's coming up on 30 days from the date that they received the claim from my surgeon's office. I'll update you and let you know what happened.

I'm in Houston also. :eek:

[shadst83 0]

I have FEP BCBS standard and had my lap band surgery in Mexico. I had to pay the $8000 for surgery up front, but I just got a check from BCBS for $7926.00. It took them about 6 or 7 weeks to pay.

I think it helped that I got all my ducks in a row before submitting my claim. I went to my PCP and discussed the surgery, and he wrote up notes on the visit which discussed my co-morbidities, showed my BMI of 35, and noted that LBS would improve my health and help deal with the co-morbidities. By the way, they were not severe: elevated blood pressure of 155/40, slightly elevated sugar levels, joint pain in my knees due to congenital problem with my kneecaps, acid reflux. Nothing life-threatening at this point.

Since my doctor was concerned about the acid reflux, I had an upper g.i. endoscopy done which showed I had Barrett's esophagus and a hiatal hernia.

I then scheduled an appointment with a psychologist who did an evaluation and wrote that I was a good candidate for surgery.

Finally I got surgical report from my Mexican surgeon's office as well as an itemized bill, along with a receipt showing I had paid it.

I sent in all of this information with the form you can print out online for overseas medical treatment. BCBS never contacted my for any further information, and I now have my payment. Yay!

Wow Snowbird. That is outstanding!

[Guinness_Harp 0]

I ended up choosing BCBS Basic. Got an actual approval letter after Doc submitted all of the stuff (they have it down to a system). I am getting banded tomorrow 8/8/08.

Thanks for all of your help!