when will I know if tummy tuck is covered

I went today for consult.  They are submitting the paper work today.  Doc says up to 6 weeks.  Is it really that long?  I have BCBSM PPO.  How long did you have to wait to hear something one way or the other?

Thank you

Erica

I have BCBSM PPO as well.  There was no wait time or pre-approval for TT.  The surgery scheduler went over a list of conditions.  Once it was determined I met all of them they scheduled it.  Got the statement from the hospital.....$13k and all but $50 was covered.  This was just for TT, not vertical incision.

Really??  They said they were going to submit everything today to see if it is covered.  I didn't get scheduled or anything.  I wonder why.

I just wanted to write you and tell you that you were absolutely correct.  They called me today and said I met all the criteria, and scheduled me for June 29, 2009.  They said that they bill after the procedure is done.  I am so excited!!  Cannot wait!!

Erica

Erica,
Who is doing your surgery?  What exactly are you having done?
It's so cool that you got a date right away!!!
Just remember to not do any heavy lifting afterwards, and buy some of this stuff....it's awesome:

http://www.bio-oil.com/en/uses.html

Well, I went on a few consults, and they all told me that BCBS only paid for a panni removal.  One even told me I would have to pay for my belly button.  So, I talked with my gastric bypass doc, and he said he does them. I did not know that at all.  He listened to me, what I wanted.  He is the one that I am going with.

Thanks for the info on bio-oil.  I will definately buy some.

Erica

What were the requirements Brenda?

100 lb. loss for over a year, significant skin irritation/rashes and/or skin that hung down to at least the pelvic area.

I'm not sure if different policies have different requirements for pre-approval???

Thanks!

bcbsm does not do pre auths - the doctor will get his paperwork sent back with a note and the medical critera.  In addition to the previously mentioned medical criteria - lost weight, skin irritation,  back pain, you also need to have significant time between the weight loss surgery and then plastic surgery to insure maximum weight loss and weight stability - usually 18 months. 

It is up to your surgeon to prove you meet this criteria.  If you do an he can provide the documentation to prove you meet this criteria - then he does the surgery and submits the documentation post op.