Can I Get Kaiser To Do A Tummy Tuck

Ok, it has been awhile since I have been on this site and boy has it changes.  Very difficult for me to find what I'm looking for.

There used to be a section for previous posts on topics and I don't see that now.

Anyways, I am looking for help from you guys on how to go about getting Kaiser to do a tummy tuck.

Has anyone out there had success with this?

What should I say and what medical necessity would qualify me for it?

I have a doctors appointment on Oct 24th.

Thanks Everybody,
Sabra

After fighting for over 18 months, a friend of mine was granted a "modified" tummy tuck, January 2007. It was NOT a total tuck. She was able to show that she was repeatedly getting rashes in the skin folds. She had to keep going even after being denied several times.

Thank you so much--that's what I thought.

WB to the board Sabra and might I say you look awesome!

Kaiser will pay for a pannulectomy (the removal the skin that hangs down) but rarely have I heard of them doing an actually tummy tuck where it involves muscle work. I know they require that you have proof of necessity and all that baloney.....but you know....go in their with an attitude of not being defeated to start with and more like...okay when are you going to schedule this. It might  be a situation where if you can pay for the difference they might to the muscle work too. You never know...and it never hurts to ask either!

Best of luck to you!  

OMG! Janine--you are drop dead gorgeous!  Congrats on keeping it off!

Thanks for the info. Can you advise me on what "medical necessities' I can present to the doctor?

Thanks again!

I believe you have to have documented history of rashes caused by the excess skin. I hear it is not easy to get kaiser to approve it......best of luck to you!!!

Oh, I see.  Thanks Janel--I'm going to give it my best shot.

I guess I'm luck.....

I saw my PCP for a physical last month and he asked me....so when are you having your excess skin removed?  I replied...when you refer me!  He did and I saw the plastic surgeon last week.

The plastic surgeon will remove the panni part plus pull down the excess fat/skin that remains on my upper part of the stomach so I won't have a roll.....He won't tighten muscles but he said he'll do a nice job!  Hey, that's all that counts because I don't plan to ever show off a six pack

Congrats to you Gus!  What hospital is your PCP with?

Consider researching the California law requiring CA insurers to cover "reconstructive surgery" to correct abnormal structures of the body resulting from disease.  Excess skin can be an abnormal structure of the body and morbid obesity is definitely a disease.  This statute specifies that the reconstruction need not be "medically necessary."