Post gastric bypass - GHI fighting my plastic surgery

 

I'm almost 5 years postop from my gastric bypass (120 pounds off and holding, Yay!!). In the last two years, I had a breast lift and reduction, arm lift, thigh lift and tummy tuck. I obtained a letter of medical necessity from my doctor for this and paid for it myself. I have GHI NYC through my husband and have been bending over backwards trying to obtain at least part of the money from them. My doctor's office keeps giving them everything they ask for but they keep turning me down. What's really annoying is that I had Empire Government when I did the bypass and was approved within 18 hours! I still have scars and my skin still hangs somewhat due to a need for liposuction, which I would pay for if I got some money back from GHI! I will never be 'beautiful' with this. I just wanted to stop having to load up with powder and chafing gel. Not to mention getting rid of the 'elephant swing' that my various parts did whenever I moved! Does anyone have advice?

Linda

Liposuction is considered cosmetic by all insurance companies (this is according to the insurance staff in my office).

Have you looked at seeing what your previous plastic surgeon would charge you to do the lipo out of pocket?

 

I have great insurance and they are paying 100% of my tummy tuck, thighs, arms and breast but I have to pay for the liposculping and fat distribution to my butt (or rather over the bone).

 

I am curious what insurance do you have? That's great that it covers everything.

 

Shara

Oh, I'm not set for the liposuction as yet. I'm still trying to get reimbursement for what I've already had, which is the tummy, thighs, arms and breasts.

I was under the impression that a Tummy Tuck included Liposuction, because the liposuction was done to separate the muscle from the skin, so I assumed it was included in what would be paid by insurance, if approved.

Jim

Liposuction is NEVER covered.  It is purely cosmetic and I was told by a plastic surgeon that they cannot be done simultaneously as the lipo would deaden the skin, too much trauma to the area before the tummy tuck.  Does anyone know if this is true? I'm thinking of going for a 2nd opinion.  He wasn't very responsive to my questioning and he came recommended to me by a friend!  I'm very skeptical :(