BCBS denied reconstructive surgery - now what?

I saw Dr. McAdoo in January for a consult. He suggested Abdominoplasty (tummy tuck) mastoplexy (boob job) and suction lipectomies (lipo). Pictures were taken and medical records were sent. Last month they asked for additional medical records. Today I got the letter stating they are denying my claim because it is all considered cosmetic. I already took the summer off from teaching to get this surgery done and now nothing! I am quite disapointed since I had no problem getting aproved for WLS. To wait 5 months for a denial. One bright note - or not so bright - is that I have 4 lumps in my breasts and I have been diagnosed with Fibrocystic Breast Disease meaning the lumps will reoccur and cause me problems in the future. I had one removed about 7 years ago no problem. If all of the current ones are removed, I will have nothing left. That will have to be considered reconstructive. Maybe then if BCBS covers the breasts, I will be able to make up the difference for the rest. I am seeing Dr. Lewis in NorthWest Memorial in 2 weeks. I am hoping he will do the reconstructive and get insurance to pay for it. I am also seeing a local surgeon - Dr. Kim who does the RNY locally and was refered to me by my PCP for possible surgery. I am thinking that if insurance will pay, I want someone who specializes in PS/ RS rather than a general surgeon.

Hi Heather I don't have an answer for you because I'm waiting to hear from bcbs myself. What were your medical reason for the reconstructive surgery. Were you having rashes. hernia,or muscle repair? Those are the problems I'm having. I just seen Dr. McAdoo 05/17/05 I was hoping to hear from bcbs soon, because I'm beginning to have pain with this hernia and I don't think I will be able to wait 5 months. I hope I can atleast get them to pay for the tt along with the hernia repair. I will keep you posted. JS