Question:
Question about blue cross of michigan

I have lost 119 pounds without weight loss surgery, but I still have the loose skin issues you guys seem to have. I was wondering if BCBS of Michigan traditional will pay for a tummy tuck and breast reduction without having had bariatric surgery? (They should provide a medal for me losing this weight on my own!)    — spiritgirl (posted on March 29, 2009)

March 29, 2009
CONGRATS Molly, If your ins covers the surgery it should be fine.Just call the ins. office and they can tell you or your rimary care can also tell you. If it does not as mine does not..I have been told you have to get a few really nasty raw looking areas. its a yeast infections in the folds of skin. Some of the people have had to have the Dr document this on several different occasions before us with clauses in our ins that does not cover COSMETIC surgery are able to get the surg we need. What we go thru to get what we need done is sometimes very round about.
   — tootsie52

March 29, 2009
WTG That is great I know you feel good about yourself and then you see all the loose skin. I lost 207 (I had gastric bypass 3/25/2008) I am 54 and I have sooooooo much loose skin. I can't even wear shorts anymore. I have come to term with my skin as my ins. won't pay and I can't afford the surgery. You can make yourself look good with the new spandex underclothes they sell today. Good Luck Bev
   — KajunMomX3

March 30, 2009
I used to be a Review Coordinator RN for an insurance company (not BCBS) and I reviewed these cases all the time. The buzz words for approval are "medically necessary" in that the excess skin and/or large breasts are giving you neck, shoulder, back, joint pain and infections. Be sure to note how much it is effecting your personal and/or sex life. Give as many details as possible and even take pictures from the neck down. The insurance company should return them or shred them after the review process is over. I would recommend you and your plastic surgeon's office calls BCBS and finds out exactly what they need as far as info and/pics to get the job done. If the excess skin is just unsightly and you have a hard time finding clothes, that's not going to get an approval. Try to get the name, direct extension and fax number of someone there who will handle your case. I am so proud of you and wish you the best of luck.
   — DawnVic

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