Not looking good for PS

have tried to wait nicely. But, every Thursday since my plastic surgeon said he would send in my request for plastic surgery, I have called. I was so bored at work today that I pushed it ahead by a day. It has been 4 weeks since I saw him. He said that they would have the request sent off within a week of my appointment. For the sake of keeping the story short, I will skin the run around I got and just say they said they sent it in yesterday. Although, I am not all that sure it has gone in yet. The doc's insurance gal was a ray of sunshine. She said that she is 100% certain I will NOT be approved for a TT. It is a complete flip from the surgeon being so sure he could get me approved. She said that Tricare is hardly approving anyone anymore. And, she said that she has seen women with skin hanging down to their knees approved. So, it doesn't look good for someone like me that just wants to look better when those *****ally need it can't get it. She went on to say that as soon as I am denied, she will get a quote for me so I can go ahead and make plans to self pay. Hum, I have four kids to support. My husband still is unemployeed. And, I am making $8 an hour with no benifits. We can't even afford water for the money tree. At least I can still enjoy hearing about everyone else. Sad but not bitter here. Hat

Well, it's not over until the fat lady sings....oops, wrong place for that saying! Don't give up just yet - who knows, you might just get your approval. I doubt that I'll ever get approved through insurance, so unless I find some benevolent benefactor, I'll be squishy and saggy the rest of my life. Hey, I'm still better off than I was a year ago. Keeping my fingers and toes crossed for you Hat! Hugs, Nancy -112

My husband had his tummy tuck and boob job (every gals dream) last year. His doc told him insurnace "probalby" wouldn't cover it. Well, it didn't cover it. Hubby happens to be an only child, and his parents are very good to both of us. They paid for his surgery. He was one of those people *****ally needed it, too. Just looking at his before and after pictures amazes me (the pics after weight loss and before PS are the one's I'm talking about--but you ought to see his pre WLS pics--amazing change). Now, we are "saving up" for my PS--I'm planning on getting it this fall after my football season is over--don't want to miss any games this year. I will get my arms done--even if it costs me an arm and a leg. I really need to, as it's hard to find clothes that fit. I bet I could wear a 14 top if it weren't for my arms. I wear a 16 top now--too big around the middle, but still tight in the arms. The lower half of me is just a mess, too. I tried on bathing suits yesterday, and, well.....I recommend Land's End swim shorts. They were flattering on me. Covered my upper thigh skin quite nicely. Anyhow, I'm rambling on. Just wanted you to know that we're here. Diana

Hat: My plastic surgeon was really optimistic that I had a good chance to get covered, and so I left my initial appt. with him feeling very positive. However, about 2 days later I got a call from his nurse saying that she spoke to their insurance girl and that she told her that my employer does not cover it and that they wouldn't even bother with trying to submit for approval. I was so crestfallen! And I had pretty much resigned myself to the fact that it was just not ever going to happen for me (because we couldn't afford to pay out-of-pocket either). But after talking to a co-worker, I decided to call the insurance myself, as well as my HR Rep- and they both told me the same exact thing. That you won't know if you don't at least try!!! So I called back my doctor's office, spoke to the insurance girl directly- and kindly asked her to at least TRY for me. That if she submitted everything and I got denied that I would leave it at that & not bother her further- but that I had a hard time accepting that she wasn't even willing to TRY to get approval for me to begin with. She told me this song & dance about how another patient that also works where I work got denied just a few months prior. I told her that I was told by both insurance and HR Rep that it was covered if non-cosmetic and deemed medically necessary. In the end she agreed to go ahead and submit. Two weeks later I found out I was APPROVED! When I found out & called the doctor's office to tell them- the insurance rep was very cold & didn't act happy for me at all. So she obviously didn't want me to get approved and that's why she had a bad attitude. I don't know what her issue was/is but I'm glad I had the balls to not take her answer as golden. So the moral is, don't give up yet! Even if it does get denied, you appeal, and appeal and appeal until you exhaust all options. We're all rooting for you! -Angela 229/144/134 lap RNY 07/28/04 arms 06/14/05 TT 08/25/05

Geez, Hat. Sorry to hear about all the BS you've been putting up with. Hang in there, and like I always say, keep smiling and keep the faith. Worst case scenario, you don't get the plastics right away, but guess what...YOU STILL LOOK AWESOME! You've done an amazing job, and we're all proud of you and rooting for you. All the love, Jeff -119