Tummy Tuck question

Hi, my insurance is bcbs and when I went for a consult with a plastic surgeon they told me there was NO WAY that bcbs would cover a tummy tuck or panniculectomy. How dod we get them to pay for this? I do not have a rash but I would love the extra skin removed. However there is NO WAY I can afford it. How are you all doing with this? Why will they pay for it for some people but not others? I DO NOT UNDERSTAND! Melanie

Melanie I dont think I am going to be much help. What I do know, is not many insurances do cover it, people end up paying for it some how, home equity loans, I dont know. I do know that the ones I have heard of paying for it have strict guidelines that you have to fall under or they will not pay either. They look for a rash, and how big the apron is. I know it has to be a substantial amount of apron hanging. I am hoping when my time to look into a tummy tuck after this baby comes, that I will fall under the criteria, and that my ins will pay. I would call your insurance and see if they have ever paid for one, and what were the conditions that made it covered. Sorry I am not much of a help on this issue, and I wish you the best in getting it covered. I really need on too, and can only pray I will be able to get it next year.- Melissa

I would definitely read your policy manual through several times and see if you see any loopholes. If it is totally excluded then maybe you can find a private medical loan company that will give you a decent loan you could pay off a little at a time. Sorry I am not more help... my insurance company has been pretty great about the whole thing but it is basically insurance for the spouse and dependents of 100% service connected disabled veterans, so unless you know a really nice 100% service connected disabled veteran you'd like to marry and take care of... LOL. Hey you could find a VA hospital and start flirting! They love that! Sorry just trying to give you a laugh!

I would try a different surgeon first off. He is not even giving your insurance compnay a chance to approve or deny you. I have heard of some PS doing this because they would rather have you as a self-pay to get more money out of it. I am fortunate and my ins. company approved me with no problem at all. I do not have rashes or anything but I do have an incisional hernia....maybe that helped the case. I wish you the best of luck... Julie S. 265/155/135 TT /hernia repair/scar revision approved....

Melanie, I for one and traveling to Brazil to have my plastics done. this is VERY commen with WLS patient's. I have been researching this paticular surgeon for atleast 9 months now, and after having spoken with SEVERAL of his client's...feel VERY comfortable going there now. I will give you his name if you think this might be an option for you. Brenda

Hi Melanie - I have NJ Plus which is a PPO of BC/BS in New Jersey. Ours covers the tummy tuck if we can prove it's a "hygine issue". My DH and I are in that process right now. We both had GBS last April (his anniversary today) and May (mine is May 5th). We took pics of our belly's last night in several views. WE have also had to fill several perscription for ointments that would be used in the creases of the skin folds. Doc says it's what the ins company has to see so they will pay. My DH needs a the large belly flap surgery - but mine should be covered with the fact that I have a hernia that was there from a prev hysterectomy 3 yrs ago. A car accident aggraviated it and now it's hugh! I'm hoping for approval sometime this summer. Wishing you the best of luck. Melissa