Approval letter including they won't pay for plastics! lol

I got my approval letter from BC BS -- Excullus the other day and finally opened it just now.  I had to giggle when I read that I was approved and in the same paragraph it says

"You should be aware that an expected outcome of successful bariatric surgery is redundant/excessive skin, and surgery to remove this skin is generally not considered medically nessary and therefore not covered"

Boy they want to make sure you know that they won't pay for that surgery. 

Curious if anyone know what has to go wrong for the insurance companys to cover the removal of the excessive skin?

Hi.  Not an expert, but I have been told as some advice to document everything.  Any problems with the excess skin (rashes, infections, etc)  Should it get down the road and you want to consider, this information could help you get it declared a "medical" necessity.

if you have problems with the skin like constant infections, or if the wieght hanging causes documented problems with back pain then they might consider it medically necessary to remove some of the skin

hi Ken, I noticed your surgeon was O'Mallie, did you like him? Would you use him again if needed? I'm trying to find a doctor and am curently considering O'Mallie, but can go to Syracuse too.

First congrats on approval for WLS!

Second many insuracnes have this as a exclusion so no matter HOW MECIALLY necessary they do not cover, this can be true forWLS as wel I am glad this is not true for you.
All you can do is document any medical necessity (rashes, hygeine issues, pain in back/groin etc) it may hel*****t...Consider doing all you can exercise, water and protein to avoid this as you can but it may be a issue even so, self pay may be the only option, many take out home equity loan, i took second job x 2 yrs to pay for mine, sometimes people can not afford and live with it.......although it may be an issue in a r or two , go forward and be in your glory right now with the new news!

I tried to get BC BS of GA (my company had their insurance based out of GA despite being employeed in NY), but they denied me saying my rashes weren't bad enough and the skin didn't hang low enough.  I was told the extra skin (aka the panni) must hang lower than the pubic area (basically hidding that whole area) and mine did not!  So I self paid for a TT and it was so worth it!!!!  They would have only paid for the panni removal and nothing above that and that was only about 30 - 50% of the cost of my total surgery anyway. 

Congrats on the approval though and good luck w/ surgery!!!!

I had it a long time ago, about 12 years ago and medicaid paid for mine then. i had excess weight in my stomach area and had a tummy tuck. I think the best way around the issue is when your ready go see the doctor and ask them if they can get your insurance to pay for it. They know how to word it so it has the best chance of happening. But I'm sure it will have to be preapproved.