Any ideas for me?

marcia w.
on 5/18/06 11:57 pm - Northwest, IN
My reward to myself for losing 100 lbs. was going to be seeing a plastic surgeon to see about removing my excess skin. I have kept pics of all rashes and skin tears, etc. I have been really excited about this. Plus, I heard that someone else on my insurance plan lost a lot of weight with Weigh****chers and our ins. covered all of her reconstructive surgery. I called my ins. and asked and they told me I would need a letter from a doc... I started calling plastic surgeons on my plan and no one would help me. Most would not even touch WLS patients. I found one that does, but he won't deal with ins. I talked to his insurance coordinator and she said that they won't cover it no matter what. She said these things have cosmetic codes that automatically get denied. I told her that they said if it were medically necessary, they may cover it. She said they will tell me anything over the phone. So, I asked if the doc could just write a letter stating that I need the procedure because of the rashes, etc. and I could just send it to the ins. myself. She said he won't even do that. So, now what do I do? If I have to pay for it myself, I will do everything I can to come up with the money, but if there is any possibility my ins. will help pay for it, then I want to try that first. Marcia
(deactivated member)
on 5/19/06 4:54 am - Cleveland Heights, OH
I'd suggest contacting your WLS's surgeon's office and asking if they have any plastic surgeons that work with their WLS patients. I can't believe that none of the plastic surgeons in your area will deal with your insurance! Have you tried asking the insurance company to identify plastic surgeons that are in your network? Perhaps you can start there and work "backwards" to find a surgeon that will work with you. I'd definitely push to find someone that will accept your insurance. My insurance has the same rule as yours - will pay for removal of skin w/ medical proof of rashes and/or infections - and you can bet I'll push until I find someone that accepts my plan! Good luck to you on your efforts. I know you'll ultimately be successful Kellie
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