Question:
What (if any) does Aetna PPO cover as far as brachioplasty,lower body lift,

and breast lift (I am now flat as a boy). I need a facelift too, as both sides of my face are different-one side more saggy than other), but know that this probably won't be covered. What is the going rates for these surgeries? I live in Ky, but would like to see Dr Dennis Hurwitz in PA since he does all these needed procedures in 1-2 surgeries. Is this even reasonable/possible to have these procedures done in another state? Any help in any of these inquiries will be GREATLY APPRECIATED!! p.s. I looked under previously asked questions and could not find the link to a question dated 6/14/01. It had said to look for a link that says "back to coverage policy bnfts". I haven't been able to find info on this on my regular Aetna PPO site either.    — bufordslipstick (posted on July 6, 2006)

July 6, 2006
Where do I start???? I am not sure that you want the recovery period necessary to do that much work in 1-2 surgeries. It is very hard on you to be under anesthetic for more than 8 hours at a time. Also, it is not healthy to have more than 2 areas worked on at a time. You need to have a consult with several PS and start prioritizing your procedures. Also, document everything with your PCP and take lots of pics. This will help you to get some coverage from Aetna if available. Some group policies have permanent exclusions so you need to ask your benefits coordinator to see if there is an exclusion or if you just need to show medical necessity. If there is not an exclusion, then go the the American Society of Plasic Surgeons Web site and search for policy statements. They have a policy statement on body contouring following massive weight loss and another one on breast reductions/ reconstruction. Take a copy of both with you to your PCP and start documenting the problems you are having so that he can write a letter for you in a few months. Don't rush into this. Plan it out and get it documented then save your money or get a 2nd mortgage to pay what the insurance doesn't. For example they may pay for the breast lift, but they never pay for implants so that is a private pay portion. Also, do some research on the supplement L-Glutamine. This helps with body toning and will help you to get the muscle tone you desire once the excess skin is removed. You need to start taking it before each work-out now. Hope that helps, Hugs from your Okie friend......
   — wealthgvr

July 6, 2006
I too live in KY and had Aetna (HMO) when I had surgery. They would not pay for any of my plastic surgery!! I finally had it done at UK and got a discounted rate because I let a cheif resident do it for me (he was supervised by an experienced surgeon). I too only had 2 procedures; first was a belt lipectomy (they went all the way around my middle pulling up & down); Next I had breast implants, thigh lift, arm lift, "back lift", and my stomach was pulled again from a different angle!! Both surgeries were ROUGH but I survived! The only thing is after the second one, since they were working on so many areas I lost allot of blood and I am STILL VERY ANEMIC!! So just be careful, and take lots of time to recover! It is hard after allot of procedures because you hurt everywhere and are pretty limited in movement for a while! And don't be like me, I ended up pregnant 5 months after surgery, so the $20,000 I spent is being wasted. I hope I can recover from my body stretching while pregnant!
   — GAYLE CARMACK-LYONS

July 8, 2006
i have Aetna ppo as well, and it does say on their site (unde clinical policy for plastic surgery) that they will not cover any of these, as they consider them cosmetic only. They might cover for removing the excess skin from you tummy, but not a tummy tuck or lower body lift, and they will only pay for the removal of the extra skin if you document that you get rahses under there. The rest you have to pay for on your own. doctors around here chaarge 1300 dollars or more just for the lower body lift. then there is the hospital to pay, as well as the anesthesiologist, etc.
   — Novashannon

Click Here to Return