BCBS PPO STATE OF FLORIDA DENIED PLASTICS WORK

HEY ALL,

I HAD THE SURGERY 3 YEARS AGO. AND AT THE TIME I HAD BCBS OF ALABAMA WHICH PAID EVERY DIME OF THE SURGERY. CAN ANYONE TELL ME IF THEY HAVE HAD THE SURGERY AND CURRENTLY A STATE EMPLOYEE WITH BCBS STATE OF FLORIDA LOOKING TO HAVE PALSTIC SURGERY. I WAS DENIED AND I'M IN THE APPEAL PROCESS. IF ANYONE HAS TIPS OR ANSWERS TO THIS SOLUTION PLEASE ADVISE. YOU CAN SEND ME AN EMAIL TO MY PERSONAL [email protected]. ANY EXPERIENCE APPEAL WRITERS ON BOARD. THANKS

Latonya-
Much will depend on the reason you were denied and exactly what your policy states.  You will need to get a copy of your policy.

Most Insurance Companies see Plastic Surgeries as Electives not Medical Necessity to remove the excess skin we now have as the result from losing weight.

Hopefully your Primary Doctor, with your insistance. Has been documenting the appearing excess skin and any problems that have come along with it. Such as rashes, broken open skin sores, muscle aches & pains, etc. Many forget along the Weight Loss Process, but taking pictures is a great way of proving the the Excess Skin is a problem and that makes it a MEDICALLY  NECESSARY .

There are only a few Plastic Surgeon that I know of in Florida, that will actually fight the Insurance Companies to get them to pay for these Weight Loss associated surgeries.

http://www.albearplasticsurgery.com      and      http://www.drbaddoura.com/

They are both located in the North Tampa area. Also if you don't mind last year medical students before they go out on their own but also supervised by their Teaching Surgeon, USF in Tampa does Excessive Skin Removal - Plastic Surgeries at a Discount to Free sometimes..

Good Luck, But please do Post here and on your OH Profile, your progress with this subject to help others going through this also and those to come in their futures..

United Healthcare of Florida (State Employees) plan will pay for the surgery with 6 months of pre documented weight loss plan (Weigh****chers of Primary DR.).