Plastics with BCBSMA

I doubt anyone remembers me, but I see so many NEW faces!!! YAY for all of you!

Ok, I previously had Tufts, and as those of you with Tufts know, they are real arse holes about approving anything. I am suprised you do not have to take classes before having a baby, just so that they will cover it!

Anyhow, I now have BCBSMA, and am going to try again for the plastics. Has anyone with this insurance gotten easily approved for plastics? or was it a fight? what kind of documentation did you have to have or turn in? How long did it take? I know the excess skin on my panni, while not an INCREDIBLE amount, does hang over the top of pubic area, and the thighs are baggy on the inside. I lso have muscle spasms in my back, quite possibly caused from the weight of the hanging skin.

anyhow, did you get plastics covered, and how did you do it?

thanks,

Dawn

Hi Dawn,

I have BCBSMA and got my panni approved with no problem. I haven't had rashes at all. There are before and after (six weeks out now) on my profile. I have heard that there are some plastic surgeons that don't even try for approval.

Good luck!
Martha

I don't have that insurance but had a panniculectomy 7 months post op. I was approved in like 2 weeks! My plastic surgeon told me just about every insurance covers a panniculectomy because it's not considered cosmetic. She also said she never saw an insurance pay for any lifts, tucks, etc. I tried to get my thighs done and my insurance wouldn't cover it.

Hi Dawn!

I was "notCasey" for a while - but I remember you!  I hope life is going well!  I've still got Tufts, so I'm going to start collecting aluminum cans for my plastics! 

Good to "see" you!

Sue

hi Dawn..

I have BCBSMA and the initial submission from my PS was denied.  I wrote a letter along with my PCP about the need to have the skin removed b/c of rashes etc and sent it to the appeal committee.  They approved the panni within a few days of reviewing the appeal.

Good luck!

kim

This is good news to hear!!
 
I have BCBSMA as well and am going to be looking into getting plastics next fall.  It's nice to hear that it doesn't seem to be that troublesome!

I have  BCBSMA and I was denied 3 times by three different plastic surgeons.  I ended up being a self paid patient.  Good Luck!

I used to have Cigna, and though I had doctors letters of necessity and all that jazz, I jumped through hoops for over a year trying to get them to cover my tummy tuck with no luck, so I finally paid for it myself, and added on a breast augmentation and breast lift at the same time, since it reduces the cost when you lump them together.  It cost a pretty penny but I would do it again, as it desperately needed to be done.  Good luck with getting yours covered. BTW, I had my plastics at Memorial Hospital in Worcester, my surgeons name was Dr. Lalikos, a woman, I would go back to her again if I ever needed anything.

Good to know, UMass is my home base for all my WLS stuff.  My surgeon told me at my year appointment to start taking pictures of rashes (and if I "needed to not use powder for a few days before I take pictures that's okay") and making lists of "things that weren't working right" due to the extra skin (sex, shaving legs/hoo-ha etc...). 

From what I've heard from others at the monthly discussion groups at UMass they really work  well with the patients to advocate to get plastics covered...we shall see!!