first consult next week!!!

ericas623
on 4/13/09 5:00 am - Roseville, MI
I called a dr's office today to get in for a consult.  When I asked about the insurance coverag,.  (I want a tummy tuck), they stated that my insurance, BCBS, would only cover the panni removal.  I knew that was wrong, a lady at my work just had a tummy tuck and it was covered.  The only requirement was that you had to lose 100 pounds.  I asked her about this, she said well we have only been able to get the panni removal covered.  Nope not going there.

I called another office that is affiliated with this site, and another one.  So I have a consult on Monday and Tuesday.  I asked them about insurance coverage-they said the same thing-as long as you lost a hundred pounds.  I even told them that I had pictures of rashs.  They said I could bring them in if I wanted too, but it was not necessary.

I am so excited!!!  I don't know how my WLS doc is going to be.  I asked him on my one year, back in February.  He said to give it some more time.  Well I am 1 pound away from his goal.  My BMI is 22, and I have been at this weight since January.  If I could get some of this skin off, I would be right below his goal.  I see him again next month.  I will talk about this again with him, and let him know that I went on a few consults.

Erica
gypsywoman6789
on 4/13/09 5:22 am - Hudson, NH
I went to 3 different PS's and got 3 different stories.  The first one is affiliated with the hospital where I had my wls.  He recommended an anchor cut panniculectomy b/c of the way I carry my excess weight.  He took his pics of me , asked a few key questions, prepared his notes and sent my paperwork off to my insurance who is anthem bc/bs.  I had no idea what to expect.  Within days I had an approval which is pretty unheard of but nonetheless I had it for a "panniculectomy" which is the tt with no muscle tightening which was fine with me.

PS #2 told me that insurance would, under no cir****tances, cover an anchor incision that they would only cover a panni removal below the belly button.  I told him I already had an approval as submitted by PS#1 but he just held fast to nope, no way, no how, does insurance cover that.  So I called PS#1 to verify what exactly they had submitted, to make sure it was the anchor cut and tehy tell me they do them all the time and don't know what this other PS is talking about.  So  I decided I wasn't going with PS#2.

PS#3 told me he would also do a hip to hip and not anchor, again b/c of insurance but he didnt' hesitate to talk me into paying out of pocket for "upgrades" such as a circumferential body lift and lipo etc etc.  He was trying to skirt around the insurance approved $ limits by adding on the "cosmetic" procedures that he could bill me for in full.  So I didn't go with him either.

Went back to where I started which was PS#1 from my wls program.  They do this all day every day and know how to handle the insurance companies and I felt he was going to give me the resutls I wanted by doing the anchor cut.  I knew if I had just a hip to hip I would still have this huge muffin top because of the way I'm built and I didn't want to go through surgery twice.

Now I will say that I have heard over and over that insurance will not cover the muscle tightening because that is purley cosmetic UNLESS they are doing a hernia repair at the same time then it is medically necessary, so find out if your coworker had a hernia repair done or if perhaps you have a hernia that could be repaired.

So there's my 2 cents!  Good luck.
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