Insurance Company denied my Panniculectomy

They say its cosmetic.... Saying that my Panni is not down passed the pubic area........WTF!..... Its all about the almighty dollar because that Plastic surgeon brought me in twice for photos and consults and probably had a clue that it would not go through. When they say at or below the pubic area...do they mean that you should not be able to see any pubic area when you look in the mirror? My panni is low but the twinkie is still a little visible facing front. So I am guessing that they mean passed "the end" of the public area.


ETA:

I am bummed but all the more reason to stay on track....

It will be well below the end of the pubic area....after I lose a little more of  this stomach fat.  Probably for the best because I will have the best results...closer to goal.

I think they approve it faster if you have a rash to go along with the hanging skin.  My skin isn't hanging much but I do have a rash from that little bit of extra skin that I have.  If I get to goal then I may give it a shot in trying to get a panni or a tummy tuck done. 

Yes...they mentioned that too Tsunami but I have medication that I have been taking for the last several month and yet they say they have no documentation of it...or that my surgeon did not provide the info. My primary prescribed the medication. I am like...well you Highmark BC are paying for the precriptions ...don't you have record of it? I am going to dispute it ...just for the heyl of it. Thanks for your response.

yep - they mean is 'fluffy' invisible cause of pannimae.....LOL

lemme ask you - do you hold your stomach in naturally? like - is it just what you do?  Let your muscles totally go and hang loose and see - mine already hid 'muffy' with no problem, but when I let go - she needed a search and rescue party!

give it a lil more time - insurance is a drag, but hey - you want to give it up? 

Yeah....you right. I don't hold my muscles in but even still I can still see it. I am just going to hang in there (no pun intended). They don't know...that they just started a game with me...and I be dayum if I lose..in the end...I will just keep moving forward and I know that I eventually will get approved.  Honesty...I still have to come out of pocket $5k for the upgrade to TT. When I looked at the original paperwork...it would cost like $9000 if not approved...so the insurance would pay like $4K for the panni. Push come to shove...I will just come all out of pocket.......BUT until they put Plastic Surgery on Priceline.com....I guess I will stick with the insurance.... I's very frugal.....aka cheap.  Well...with these too little money pinchers of mine....no other way to be.

Where are you weight wise?  gimme your start/now/goal

depending on where you are - this isn't the right time anyway - you could get a TT, lose more and need a touch up - THAT would suck - TRUST me..... revisions are no fun at ALL~!!!!! 

Well my high was 316...preop...306...current 205 yesterday...my goal is 180. Honesty my goal will be whatever weight I am at when there are no excess fat deposits visible..- 5 pound cushion. I have a large frame ...so anywhere between 165-175..I should be good to go. No less for me. Not sure how much weight the skin will take off... So another 30 pounds and I will at or very close.

Aww.....MD........Here's a big hug for ya!............Sorry it didn't get approved this go round.  But I know you will keep pressing on!  You're still phine anyway!....

J

Thanks Janice.....I am okay with it....you know what they say...everything happens for a reason....I know I would look better after I lose some more anyway plus this will give me more of an opportunity to shop around for a Plastic Surgeon with some WLS recommendations. I really did not like my surgeons attitude anyway. He was referred to me by my WLS sugeon so I just took it and ran with it.  Thanks for the hug and compliment!

Be encouraged my sister and definitely appeal. It is such a game with these companies. They are hoping that with the denial you will just go away. I went through this with social security. I know you will prevail. peace mz jojo