Removal of Excess Skin???

I had bypass almost 2 years ago and have lost about 130 lbs. I have lots of excess skin in my lower abdominal area, thighs and arms. Does anyone know if BCBS will pay or help for removal? And does anyone have any surgeon recommendations for patients of baratric surgery? I have constant rashes, boils and irritations in these areas. It is very unpleasant to say the least.

If you have medical documentation (pictures are really good) and a doctor to write your letter of recommendation BCBS will pay for some surgeries.  They may not cover thighs.   Check their website and they will tell you what kind of documentation you need.  I do know that you have to have lost at least 100 pounds.  

Lisa,

Be sure that you are going to see your Dr. regularly about your rashes and are not self treating them. Also contact 'Cagair' she has the BCBS requirements for plastic surgery and said she'd be glad to share.

 

hehehe thanks Barbara! Hope your doing well, sorry I missed the meet this Saturday. Working this 2nd job is kicking my rear and I'm trying to get use to it. Dalton promised he'd send my hello's and hugs to everyone.  I've already gotten a couple of emails about this from your post, so I thought perhaps I could list it here in for those that don't know me.

Here is what I got from BCBS:

A panniculectomy may be considrered reconstructive when ALL of the following criteria are met: ***Note: Photographs and documentation may be required.

1.  The pannus hangs at or below the level of the pubic symphysis ..AND
2.   Causes recurrent and significant bacterial cellulitis, that has failed at least 2 treatments with an oral antibiotic...AND
3.   Is unresponsive to conservative treatment including adequate hygine and topical anti-infective medications...AND
4.   Has been present for over a 6 month period resulting in fibrosis and thickening of the pannus with discoloration and/or lymphedema or peau d'orange effect (pitting or prominence or pore due to fibrosis and swelling) of the overlying skin .... AND (if applicable)
5.   If there has been significant with loss (>l00lbs) the member must meet the criteria above AND
      a.  If the weight loss was accomplished without bariatric surgery, the member must have maintained a stable weight for a minimum of 6 months OR
     b.  If the weight loss is a result of bariatric surgery a panniculectomy should not be performed until at least 18 months after the surgery and only after weight has been stable for the most recent 6 months.


My suggestion is that 1) if they deny you or you are missing 1 of these, see if you have something they don't have listed and substitute it with documentation on the appeal.
2) See if your health plan is managed care through your company. If it is, you can appeal (assuming they deny the first attempt) through your HR department.

For example, I've got documentation of lots of back problems from my skin and several thousands in $$ for trying to releive the pain. Foot issues, skin issues, etc - none of it listed in their requirements.  So if you don't have ALL of their requirements, if you have others, it's worth the fight.

Also remember, they only pay for the panni removal. Nothing else. For example, I will have an extended abdomnioplasty.  They aren't going to cover all of it, but a good portion for the panni removal. At least it's something!!!!