PS ?

Hi Y'all, I finally called my insurance (Blue Shield Access+ HMO) to see if they cover reconstructive surgery. I am not ready yet but if I have to fight I want to start now......Well to my surprise, I was told that if my PCP determines it to be a medical necessity, they do cover it....WELL blow me down! It seems too easy. Has anyone else been successful with their insurance company covering it? What did you have to do? Etc, etc......If you don't want to post it here, please email me at [email protected]. Thanks Sheryl

Hey Sheryl, I was just looking into PS as well. I have Blue Cross PPO. I was looking into a few different procedures, but was mainly concerned about my tummy. I had to go in and have some completely nude photos taken. (That was lovely.) I then had to get a letter from my WLS doc telling how much weight I've lost, a letter from my pcp telling about my skin rashes, and one from myself telling what its like to have to live with this excess skin. It didnt really seem too hard to get it covered, especially if you have a hernia. If not, then you can go the hygeine issue route. They seem to cover it if you have rashes and such. Unfortunately, even though Blue Cross would ordinarily cover it, my husbands employer had elected to not include such coverage in their benefits. Therefore, I am temporarily stuck with all this extra skin. We are currently talking to the folks at home office and trying to get them to include this type of coverage in their benefits in the next open enrollment. Unless they do, we are looking at about $6,500. I hope that you are successful in your efforts to get your's covered. Keep us posted as to how it goes, and good luck!!!

Hi, Sheryl: Congrats on the insurance (potential) approval! You are way ahead of me on that one. Not only did my insurance NOT pay for the bypass last year (October 25, 2004) , but I can kiss another major lump sum goodbye for the next procedure. I am having a full lower body lift (body sculpting) on November 18 (a little over a week away; tick tock!!). I'm not really worried or stressed about it. I mean, after living through GB, this is "just" major pain, but not on the same level of "scary." (and, besides, I'm actually looking forward to the three weeks off of work!) (By the way, my insurance company DID tell me they thought I needed the gastric bypass procedure last year. They encouraged me to go ahead and do it ... it was just that they just wouldn't pay for it.) Good grief. Anyway, the gastric bypass surgery cost me $20K. This procedure is costing $15K. Hey, it's only money -- and I figure it this way: I'd spend if buying a new car, finance it, and pay it off over five years. Then I'd need a new one. The new body and health will last me much longer. And I'm worth it. (So what if I had to refinance the mortgage?!) After 135 pounds lost, I really need the lower body lift. (Although I do get seriously entertained by the ridiculousness of the loose skin!) Aside from the obvious physical (saggy) issues, it's become a morale issue, as well. You can't help but feel that you're still "fat" (even tho logic tells you it's impossible). My plastic surgeon gives a discount to bariatric patients and tells me he believes that I am going to have EXTRAORDINARY results (now THAT is what you want to hear!). He's kind, caring and very talented. I am really looking forward to an improved self image. The way I've chosen to view it is this: it's kind of like wanting to get rid of your fat clothes. You don't want to keep them around, because it's a reminder of what you were (and makes it easier to go back), and it's a reminder that you used to be something you're not real happy about. So, I figured, get rid of the fat clothes ... get rid of the fat skin. Don't need it any more. Best of luck to you!! -- Darcy

Who is your Dr?. I am from Ct. and will travel. I have the skin and I want a body lift but I only had 75 pounds to lose as I had other health problems. Please give me some info or your Dr's name so that I can contact them BlkNectar [email protected] Thanks so much!