Aetna-tummy tuck- approval?????
On April 9, 2012 at 11:41 AM Pacific Time, Lucky Lu wrote:
Aetna approved me because I went to my PCP and had my rashes documentd and treatment documented. The tummy tuck became a medical necessity.If you want a friend, show yourself friendly!!
Some of it is about Aetna, and some is about the particular policy YOUR employer has with Aetna.
They may or may not have coverage for plastic surgery.
It is very possible that your procedure would be considered 'reconstructive' and not 'cosmetic' and will be covered.
It is possible that your insurance will pay for a panniculectomy (the removal of the apron of skin only) and not a full Tummy Tuck (muscle tightening, skin removal, lifting of the mons, re-design of the belly button).
Sometimes you can pay the difference between the panniculectomy and the TT --- it all depends on your surgeon and the insurance company.
It is a good sign that your doctor is behind you. Now, you should contact your insurance provider and ask what steps you need to take to move forward. I would not ask IF they cover it, I would read the policy and that ask HOW to proceed.
I would also recommend you interview 2 or 3 plastic surgeons --- and discuss insurance with them as well. Some of them will help you with the submission, and some don't do that and leave you on your own to file the paperwork.
Good luck -- check out the PS forum here.
They may or may not have coverage for plastic surgery.
It is very possible that your procedure would be considered 'reconstructive' and not 'cosmetic' and will be covered.
It is possible that your insurance will pay for a panniculectomy (the removal of the apron of skin only) and not a full Tummy Tuck (muscle tightening, skin removal, lifting of the mons, re-design of the belly button).
Sometimes you can pay the difference between the panniculectomy and the TT --- it all depends on your surgeon and the insurance company.
It is a good sign that your doctor is behind you. Now, you should contact your insurance provider and ask what steps you need to take to move forward. I would not ask IF they cover it, I would read the policy and that ask HOW to proceed.
I would also recommend you interview 2 or 3 plastic surgeons --- and discuss insurance with them as well. Some of them will help you with the submission, and some don't do that and leave you on your own to file the paperwork.
Good luck -- check out the PS forum here.
Aetna would only approve a panniculectomy for me, NOT a tummy tuck with muscle tightening or removal of skin above the belly button. I had to do that as an extra surgery at my own expense. It is hard to justify a medical reason for needing muffin top skin removed and your abs tightened, but good luck...
Lora
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
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