PS Insurance Help!! Please!

CarolDE
on 4/6/07 12:46 am
I'm 16 months out and just visited the PS for the initial evaluation. Here's my insurance dilemma. Any feedback about these companies or your experiences are welcome. I currently have BCBS through Empire Blue Cross, but I'm leaving my job and the benefits end 4/30. Instead of cobra, I plan to go on my husband's insurance, Aetna HMO. I am starting a new job which will offer insurance after 90 days, so that's August. According to what I see here, and the PS office, can take 60 days to approval. I didn't want to cobra BCBS because of the money, but my history with them has been that they approve and I just don't know enough about Aetna and the new job is just too far away to know anything (I start next week so don't know about insurance yet). Help!! What should I do?? I know they are not all the same and PS says there has been dramatic cut back and only about 25% is approved now and I can't afford to do it on my own. All feedback is welcome. Thanks for your help. Carol
DLMoore
on 4/12/07 4:08 am - Wilmington, DE
It's been my observation that MOST (not all) PS is refused by insurance companies. The ones that I do know that got it covered took several YEARS worth of documentation (rashes, etc) from several doctors in order to get their insurance to cover. You also have to make sure that the PS doc codes the surgery as "reconstruction". Also, most doctors (not all) want you to have maintained your weight for about a year before doing PS. Read your insurance policy. It will tell you if reconstructive PS is on the exclusions list.
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