X-POST Useful Medicare PA insurance nugget
In my quest for prior authorization to have excess skin removed from my thighs, I got this little nugget of information from Medicare - I'm going to check with my replacement plan to find out if it works this way with them:If the surgery is done on an outpatient basis - insurance *cannot* be submitted for prior authorization retroactively. GUARANTEES non-coverage.
If the surgery is done INPATIENT - including hospital stay for at least 24 hours post op - retroactive PA can be done *up to 90 days post-procedure* They could conceivably still deny, but I'm thinking if inpatient is necessary, they would be nuts not to! If they did, you could still appeal!
HW 405/SW 397/CW 138/GW 160 Do the research! Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!
I paid taxes all the 30+ years that I worked, Brianna, and I absolutely *RESENT* your implication that I am sponging off of "you, the taxpayer"!
My taxes probably paid for your arrival on this planet!
I went to college, got my education and went to work. Hell, I went to work at my profession even before I graduated, never once imagining that I would end up on Social Security Disability.
Do you think that I planned prednisone-induced weight gain? Had I not had lupus, I wouldn't have even been taking prednisone!
Apparently you did not read my previous posts regarding cellulitis infections in both legs, due to compression garment abrasions. This has happened multiple times. Also, I must go to extaordinary efforts to clean under all the skin flaps and folds.
This is *NOT COSMETIC* for me. This is a medical issue.
Cellulitis can quickly go into sepsis, and with multiple infections of any kind, and multiple uses of antibiotics, you run the risk of antibiotic resistance and failure, which is the gateway for sepsis, while your health care providers scramble to find antibiotics that will work.
The same thing happens with SMO people when we get skin breakdown, as I did before I lost the weight.
I paid taxes for the 30+ years I worked, That's just like paying for disability insurance as part of your job benefits. I'm trying to get back to work. I'm in Voc-Rehab, training for a different profession more accomodating to my lupus and fibromyalgia, which has improved some with the weight loss, but is something that I will have to deal with for life.
I'm only getting skin excised, this will not be a true "thigh lift", unless the surgeon "gifts" me with that, or finds that's the only way to correct my *MEDICAL PROBLEM*.
I have a suggestion, Brianna. Next time I get an infection, why don't you come over and take a look? It's an infection that can get into your bloodstream very easily! Perhaps you think I'm speaking of cellulite which is quite different, and yes, that would be a cosmetic issue, but this isn't.
I've probably paid taxes longer than you've been alive, Brianna. .
My taxes probably paid for your arrival on this planet!
I went to college, got my education and went to work. Hell, I went to work at my profession even before I graduated, never once imagining that I would end up on Social Security Disability.
Do you think that I planned prednisone-induced weight gain? Had I not had lupus, I wouldn't have even been taking prednisone!
Apparently you did not read my previous posts regarding cellulitis infections in both legs, due to compression garment abrasions. This has happened multiple times. Also, I must go to extaordinary efforts to clean under all the skin flaps and folds.
This is *NOT COSMETIC* for me. This is a medical issue.
Cellulitis can quickly go into sepsis, and with multiple infections of any kind, and multiple uses of antibiotics, you run the risk of antibiotic resistance and failure, which is the gateway for sepsis, while your health care providers scramble to find antibiotics that will work.
The same thing happens with SMO people when we get skin breakdown, as I did before I lost the weight.
I paid taxes for the 30+ years I worked, That's just like paying for disability insurance as part of your job benefits. I'm trying to get back to work. I'm in Voc-Rehab, training for a different profession more accomodating to my lupus and fibromyalgia, which has improved some with the weight loss, but is something that I will have to deal with for life.
I'm only getting skin excised, this will not be a true "thigh lift", unless the surgeon "gifts" me with that, or finds that's the only way to correct my *MEDICAL PROBLEM*.
I have a suggestion, Brianna. Next time I get an infection, why don't you come over and take a look? It's an infection that can get into your bloodstream very easily! Perhaps you think I'm speaking of cellulite which is quite different, and yes, that would be a cosmetic issue, but this isn't.
I've probably paid taxes longer than you've been alive, Brianna. .
HW 405/SW 397/CW 138/GW 160 Do the research! Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!
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My insurance will not pay for my excess skin that hang down to my knees
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