Question Re Kaiser and Skim Removal

Anyone know whether Kaiser will cover skin removal due to significant weight loss? I am going to self pay for a DS since Kaiser doesnt cover that and I don't want RNY. But I was wondering whether they'd cover skin removal since they cover WLS in general. Also, would they cover post-op care for a patient who self-payed for the DS surgery that they didn't cover? Any insight you have would be appreciated. Thanks!

Cheryl: I don't think that Kaiser will cover anything but the RNY surgery. I had surgery on August 22nd, and I have a good amount of skin to remove, especially my bat winged arms. Peggy

I'm new here so I could be greatly mistaken. I heard in the informational seminar I attended that most insurance will not pay for your skin removal unless it is a health problem, i.e., makes it difficult for you to walk, causes severe rashes and sores, etc. I'm going with the RNY and praying my insurance (Regence BC/BS) will pay. That way, I can plan on using any funds I can scrape together for the tummy tuck and the bat wing lift I will undoubtedly need.

Hi Linda: If your BCBS plan will cover weight loss surgery at all, but say they won't cover DS because they deem it "experimental" you should be aware of a recent court decision (granted, it's out of an Alabama jurisdiction, but is on point so I think it would carry weight) that basicaly overturns BSBC's decision to not cover DS.. Of course, this assumes you would prefer the DS if your insurance would cover it, but I could have misinterpreted. As to the skin removal, I understand that no one will really cover it unless it's causing problems. So.... assuming it does cause problems, I wonder if Kaiser covers it. I have BCBS of Oregon and unfortunately they have an airtight exclusion against WLS of ANY kind pertaining to my policy. But, I have the option of switching to our Kaiser plan during open enrollment at the beginning of the year, and since they DO cover some sort of WLS, I wondered whether the chances of getting post-op care covered through them would be possible. I'm just having the darndest time getting the ansers to that from our HR department.

It really is the pits trying to get good insurance information. I know that Regence BCBS covers only the RNY procedure, and I think the Eugene Bariatric Center does only the RNY and Lap Band. I have, however, been hearing more about DS, so I'll be sure to look at that option given the information you shared. Thanks, and I hope you manage to get more info on Kaiser. Linda

Hi, I have Regence BC/BS of Oregon and they have the exclusion of NOT paying for any kind of WLS. I had to self pay and it was the pitts. BC/BS would not pay one penny toward my surgery!! I begged, pleaded, cried, medically necessary the works, still they would not pay! Now I have someone in HR checking into skin removal, and I hope they will pay for that when my time comes.