BCBS of Texas Federal Employee Plan

[Sleeyt]

Has anyone had success in being reimbursed for cpap.com purchased equipment? I'm appealing a denied claim from BCBS of Texas Federal Employee Plan.

Thanks.

[tillymarigold]

I'm a federal employee and I switched to GEHA because my old insurance (Presbyterian, a local NM insurance plan) wouldn't cover it. BCBS is abominable in New Mexico (no one accepts it) so I haven't tried them. GEHA is amazing, though, I can't say enough good about them. I haven't met my deductible yet for this year, though, so I don't know how problematic they'll be if I try to get them to cover supplies. We'll see what happens if/when I do ... it's a reasonable deductible but I doubt I'll meet it unless I need a new machine (knock wood I won't, I got the new one in December) or one of us needs surgery.

[gasparama]

I have BCBS fep for my secondary insurance. My primary carrier warned me that I would probably be turned down for a reimbursement if I used CPAP.com. So, I didn't bother to ask BCBS fep if they would reimburse for internet purchases because I figured that it wouldn't do any good. On the happy side, I have a pretty good, locally owned DME who is a provider for both insurances, so I don't have to make any claims. I think in the 18 months or so that I've been on therapy I've paid $8 for the machine, the mask repairs, the 4 masks, and the filters. I've bought about 3 other masks and extra equipment from CPAP.com, but I've never tried to make a claim on it. I'll be interested to see what happens with this.

[Sleeyt]

If they won't approve it, I'll use funds from my medical flex spending account. CPAP.com claims that some people have success with BCBS so we'll see.

[Sleet]

*BUMP*

Does anyone have any additional insight or tips?

[LinkC]

As I'm sure you know, there are many "flavors" of BCBS. But I would think the "Fed" coverage is uniform from state to state.

I'm a Fed and that's my carrier. So far they have covered all my OSA expenses (less co-pays). I pay $22/mo toward the obscene DME "rental" charges, but BCBS picks up the bulk of it.

I have heard they will not reimburse for purchased CPAP, but have no personal experience either way.

[Sleet]

Well the BCBS of Texas FEP Plan does not pay anything towards CPAP.com purchases. I'll still defray some of the costs with my medical flex spending plan though. Thank you for the input.