BCBS Federal - Any Attorneys Out There?

I had my WLS almost two years ago and have lost 170 pounds. Needless to say, I am very much in need of plastic surgery to get rid of all this excess skin. I have a problem with rashes and pain in my lower back and shoulders. I have a letter from my orthopedic doctor stating the need for surgery to remove the skin from my abdomen and arms in order to relieve some of the pain. My insurance book states cosmetic surgery is not covered UNLESS: "required for a congenital anomaly or to restore or correct a part of the body that has been altered as a result of accidental injury, disease, or surgery..." I have spoken with BCBS and OPM and both have told me it should be covered because of this wording "surgery". BCBS paid for my RNY and as a result of that surgery I have lost weight and have this skin. My problem is that BCBS is not required, under my plan, to preapprove and they absolutely refuse to do so. I have been trying for seven months to get an exception to the preapproval rule and have not been successful. Plastic surgeons all want preapproval or a whole lot of money up front (I'm retired and don't have that kind of money). I was told by one insurance rep to ask the plastic surgeon to precertify me for at least one night in the hospital following the surgery. This precertification goes through the same process as a preapproval. Therefore, if I get precertified I would be approved. Well, the plastic surgeons I have seen refuse to do this because they said they needed a "medical necessity" for hospitalization. Any suggestions on how I can get a preapproval????? Kathy

You can try Gary Viscio he is on Obesity Law.com I'm using him currently for Lapband appeal but mwybe he can be of help. He will telll you if he thinks you have a case or not he is pretty good. Good luck!!!!

It's www.obesitylawyers.com not the one you posted Jamie, but thank you for the complement.

I sent you an email via your website. Thanks for your help. Kathy