Question:
What are the key things to say in order to get insurance to cover a lower body lift?
— Alissa N. (posted on January 15, 2005)
January 14, 2005
Hi. here are not really any key things to "say." Most impostant
is for you and your doctros to document the medical problems youa re having
from the excess skin. For instance, skin rashes, irritation, ingrown hairs,
and odor. These must be documented, often by visits to your family doctor
or OB-Gyn, and photos taken by your PS. If INS has appropriate evidence,
then they cannot deny it. I have NOT found that fit of clothing, pain, and
other very real problems WLS patients have from excess skin to be very
convincing to INS.
— DrL
January 15, 2005
I know of a lady who invested in a good digital camera and took pictures of
every rash, and in grown hair and all the over hang of skin at each stage
for the documentation to go with her Drs notes because she also had
horrible back pain and when came time she had a full photo album for the
insurance company to view and got approved with no problems.
— nefish
January 15, 2005
BCBS paid for a full extended abdominoplasty to be done in two stages for
me based solely on my degenerative disc disease in L3-S1. I had no rashes
or infections. However, they could not come up with any good reason to
approve the lateral thigh lift portion which turns it into a lower body
lift. They could not see where it would help my low back. I didn't even
choose to fight it because I did not have a good answer for them. I needed
it done because of the huge saddlebags I had and the fact that once the gut
was removed there would not be any clothes that would be able to wear. The
saddlebags would have been 3-4 sizes larger than the gut and waist. So
paid for the difference. I would have the surgeon submit for the two
procedures in one request but that way the insurance can opt to approve the
one and not the other. There isn't actually a procedure code for a lower
body lift. Good Luck!
— zoedogcbr
January 15, 2005
I have been told that if you get yeast under your flaps that wont go away
with treatment. that then most insurances will cover a tummy tuck.Havging
your legs lyposuctioned and lifted is a cosmetic procedure and most of the
time it is not covered under any insurance, so i'd would say start saving
money.
— susan P.
January 15, 2005
Yes I agree with Chris...back pain aggravated by the weight of excess skin
can be a medically necessary reason to have skin removed. **And just for
the record I think PS for WLS patients is ALL reconstructive and RARELY is
it cosmetic. I do treat cosmetic patients and their issues are by and
large an order of magnitude different than most WLS patients...who simply
want to look normal. This in my mind defines a true reconstructive
surgery.
— DrL
January 15, 2005
I am not sure about the lower body lift however, I did have leg lifts
covered by insurance. I had a skin condition from a very young age I cant
remember the name at the moment so I will desrcibe it. It looked like
pimples varying in size from the size of the tip of a pin to huge biols.
The infections were deep in my skin and therefore the insurance covered the
surgery removing all the excess skin from my inner thighs. The downside is
I still have cellulite on my thighs. However, I still get boils in my groin
area so I am going to try someones method mentioned earlier, I am going to
document every boil with dates and pictures and hopefully that will
convience the insurance company to pay for a lower body lift.
Good luck to everyone. If anyone needs more info on my procedure or has
addition information for me please email me @ [email protected]
Shana
— shana1569
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