BCBCS DE: Tips on approval for breast lift?

simplygawjus
on 8/1/08 1:32 am - wilmington, de
I am 3 years post op and down 120lbs!! Which is GREAT except for the fact that my breasts now look like sweatsocks with an orange in the bottom (I'll give you a few seconds to get that visual image and stop laughing...) So I went to a PS last year for a consult on a breast lift, went thru all the paperwork and BCBS denied it saying I had no evidence that it was for medical reasons and it would be considered cosmetic. I have another consultation appointment with the same PS on August 14th and was wondering if anyone had any tips or sample letters to share.
katwig
on 8/2/08 6:11 am
I recently submitted a request for abdominoplasty and breast lift to BCBS Anthem.  So far they haven't reviewed it... they sent it back to PS once and said it was sent to the wrong address.  PS resubmitted it about three weeks ago but Anthem says they don't have it yet.  My PS said he has "never" seen Anthem approve a breast lift and was reluctant to submit it.  He finally submitted it but I am not hopeful.  I do have rashes under my breasts but I don't have enough breast tissue to qualify for a "reduction" which they are much more likely to cover.
I have greater hope for an approval on the abdominoplasty, but am prepared to appeal.
Good luck with your PS!
I am 5 years post op and down 160 pounds.

Kathy
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