Question:
HOW CAN I GET INSURANCE TO PAY?

I HAVE BCBS FEDERAL (NEBRASKA)AND THEY WILL NOT PRE APPROVE FOR TUMMY TUCK AND LIPOSUCTION.I CAN NOT PAY IF THEY DON'T. HOW CAN I GET THEM TO APPROVE BEFOR THE SURGERY. I DON'T HAVE ANY MEDICAL PROMBLES BUT SKIN FLAP.PLEASE HELP.    — Stacy M. (posted on November 27, 2002)

November 27, 2002
Insurance companies will not cover cosmetic surgery. It has to be "reconstructive" and medically necessary. That boils down to you have to have a serious rash in the skin folds. You could also have back problems due to the weight of the pannus, and balance and mobility issues as well, but my surgeon said that a rash is key to having insurance cover the proceedure. And then again, they may not.
   — Carolynn J.

November 29, 2002
Stacy, I feel for you. Obviously we are in the same boat, somewhat. We just happen to be federal employees. BCBS whether of Georgia or any place else has strict guidelines for any type of surgery. Skin flaps *may* qualify, but I doubt it-It just so happens that unless you or your doctor/surgeon can PROVE that to have the tummy tuck/liposuction is medically necessary, they will automatically assume that it is for cosmetic purposes, and will not pay. I didn't notice whether you have had the WLS recently ot not. If you HAVE NOT had the WLS, it doesn't make sense to even think about having a tummy tuck or liposuction because we have to learn how to eat FIRST, lose the weight, then wait a while before having either or both of the other surgeries you mentioned. Otherwise, you will see that not changing the eating habits and having the surgery to look good does no good. I spoke with a plastic surgeon and she told me that people who have tummy tucks and liposuction and not lose the weight first are, (in her words) "making us rich". In liposuction, they can use the instruments to "suck" the fat and fat pockets out, however, if a person continues to consume large amounts of fat, that fat simply comes re-deposits in other areas of the body. Liposuction is a temporary fix IF you haven't addressed the other issues. Check it out. Call Federal BCBS, but understand, you can't make them pay, talk with your surgeon, it may greatly depend on what medical information is submitted to the Federal BCBS Plan by your surgeon. Once that is done, they will determine exactly if it is medically necessary. Are you ready to deal with the possibility of having to fight them or pay as a self-pay?~~Yourdivaness~~
   — yourdivaness

November 29, 2002
I'm sorry that I didn't give more info. I had my surgery Oct. 2001,I lost 125lbs.
   — Stacy M.

Click Here to Return