mad as hell with shbp!!!!!!!!!
shbp insurance for States employees will NOT cover plastics BUT Medicaid WILL!
This is so not fair? So, in a nutshell if you sit on your ass and milk the government you can get your wls covered and plastics.
But, if you bust your butt in an under paid, over worked, under appreciated, FURLOUGHED state government job, you get the middle finger.
Did I mention underpaid. As in not enough income to even dream of being a self pay!!!
Is there anything right about this?
I know we shbp folks are growing in numbers and many of us have passed the 1 year hurdle and are thinking about reconstructive surgery now.
Does anyone know the process to petition shbp to add plastics for reconstructive surgery onto our plan? Contact people, phone # and e-mail addr, etc
Anyone willing to take on this battle with me?
I know I'm not the only formerly fluffy one out here wanting a little nip and tuck. :-)
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I 
MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
Where have you been? At any rate, I just saw you a few weeks ago. Are you saying you have some excess skin? Just wondering b/c if you do, you are hiding it well.
Celeste
HW 240/ SW 229/ GW 146/CW 125; OH Support Group Leader
Starting size: 18W-20; Present size: 0 or 2; 5'5-1/2" tall.
Current BMI 20.4 as of 2/13/2013 (normal for the first time in my life).
Goal weight reached on 8/12/2010; As of 1/13/2013, 21 pounds below goal
LaShelle,
I understand your point. However it's not a shbp issue. I have BCBS and they do not cover it. Most plans only cover breast reduction and the panni surgery since those are the only conditions that can be determined to be medially necessary.
Why are taxpayer dollars are going to pay for procedures that are not medically necessary is the ultimate question. With all the talk about budget cuts and deficits, that should be reviewed. However, the fact that medicaid pays it is no reason why our insurance companies should be obligated to cover plastics.
The issue we need to look at is what we can do to get our companies to cover the procedures that some of us NEED after massive weight loss.
HW 240/ SW 229/ GW 146/CW 125; OH Support Group Leader
Starting size: 18W-20; Present size: 0 or 2; 5'5-1/2" tall.
Current BMI 20.4 as of 2/13/2013 (normal for the first time in my life).
Goal weight reached on 8/12/2010; As of 1/13/2013, 21 pounds below goal
This procedure is often deemed to be medically necessary.
HW 240/ SW 229/ GW 146/CW 125; OH Support Group Leader
Starting size: 18W-20; Present size: 0 or 2; 5'5-1/2" tall.
Current BMI 20.4 as of 2/13/2013 (normal for the first time in my life).
Goal weight reached on 8/12/2010; As of 1/13/2013, 21 pounds below goal
Well it's my understanding that as a general rule, the arms will not qualify. A physician told me that as long as it was medically necessary an insurance company would pay for it.
However, Dr. Lincenberg (sp?), an Atlanta plastic surgeon who does extensive work with barriatric patients came to a support group meeting last week. He is the one that said companies would pay for the panni removal as well as breast reduction. I asked him what about other procedures. He says that he has had ABSOLUTELY NO SUCCESS getting insurance companies to pay for any other procedures, regardless of the cir****tances.
HW 240/ SW 229/ GW 146/CW 125; OH Support Group Leader
Starting size: 18W-20; Present size: 0 or 2; 5'5-1/2" tall.
Current BMI 20.4 as of 2/13/2013 (normal for the first time in my life).
Goal weight reached on 8/12/2010; As of 1/13/2013, 21 pounds below goal
Sorry to see that once again our Government don't give a flip about their employees. I have a neighbor who can not believe I will have to go through so much to have surgery when she does not have anything to do in order to have surgery. It suck and I know I will need plastic as well after surgery. Let me know what I can do to fight the cause.
Rockmart Georgia
HW: 315 CW: 117 GW: First goal 150 met 3/23/2012, Second goal 135
I am so glad that I only have one week left with the state. Hopefully my new job's insurance will cover it. if not, I am still glad that I am leaving the state.
"'I'm selfish, impatient, and a little insecure. I make mistakes, I'm out of control and at times I'm hard to handle...but if you can't handle me at my worst, then you sure as hell don't deserve me at my best."-- Marilyn Monroe
