LAPBAND One year post op
I don’t normally write on forums but I’ve come to a point in my ongoing weight loss where I’m going to need to get an abdominalplasty (Tummy Tuck). My surgeon stated that insurance should be able to cover this as it will be a medical necessity but that I will need PPO plan with bariatric surgery benefits and that I should make sure there’s no daily max for ambulatory surgery benefits.
Has anyone gone through this process with insurance? I thank you all in advance
Tim
on 9/10/14 12:28 pm
My abdominoplasty was not paid for by insurance.
Most are not.
You may be able to get a medically necessary panniculectomy (skin removal only, no belly button wot, no muscle tightening) covered if you have rashes or severe medical issues caused by excess skin.
You may even be able to pay the difference between a panniculectomy and an abdominoplasty ..... But they are not nearly the same thing.
Check with your insurance company and start documenting rashes or other issues with your medical team I case it is needed for proof.
Not personally but from things I have read on here you need to be able to prove medical necessity by medical records and to have been at your goal weight for a specified period of time.
In the UK, medical necessity would be such a large area of skin that it made movement difficult, serious/intractable rashes or infections. I don't know how much weight you have lost but with the band, in one year, it may be that the amount lost may not have left you with enough skin for this. My 110lb loss has left me with a big flap but not enough to qualify me for anything other than self-pay plastics. People who do get it paid for are often those who gave lost 200 or 300lbs.
Highest 290, Banded - 248 Lowest 139 (too thin!). Comfort zone 155-165.
Happily banded since May 2006. Regain of 28lbs 2013-14. ALL GONE!
But some has returned! Up to 175, argh! Off we go again,