Plastic Surgery & Horizon NJ Blue Cross coverage

Good Morning!

One of my to do list items for 2011 is to research plastic surgery.  Did your Horizon NJ Blue Cross cover any portion?  I am aware that it is covered under reconstructive therefore certain
conditions must be met. 

What was your experience? 

Thanks in advance for any input,

PS

I had blbsnj number of years ago before wls they did cover my breast redeuction due to medical necceisties I had to have it shown by my dr that I had to have it, My drs took pictures of my breast because I had bisters and infections underneath them and NO Medication would work to clear them up. Now when I go to to the dr I have them write down the rashes I get from hanging skin and the mdication  they give me to clear it up. I now have Medicare so I don't know there requirements.
Good Luck
Cathie 

I just had a LBL on 12/30 and had pre-approval for a portion of the surgery. A LBL is considered partially cosmetic so I will end up paying for about 2/3 of the Dr's fee when it is all said and done. I could have had just a pannius removal and it would have more than likely been covered 100% but I would not have been happy with the long term results..

Here is what I did, I called the insurance company and asked what my policy covered. I made them send it to me in writing and I took the name and operator number of who I spoke to, keeping detailed notes. It really depends on your plan if you will be covered, the plan that I had available to me at my work stated it did not cover skin removal "regardless of need".. The plan my husband had available said it had to be medically needed. I had to document skin conditions, my pannius needed to extend below my pubic area and they wanted pictures (that was the worst part) but I was able to get approval and am very happy with my results.

Good luck, I hope you plan is a good one and does not exclude.

Stella

Thanks Cathie & Stella!

No problem, good luck ! 

I actually had to rush my LBL thru for 2010 since in early November we found out that my husband's ins was changing and the new plan had a ton of hoops to jump thru to get approval so I pushed (along with the people at the plastic's office) and we got approval on 12/17 and I had surgery on 12/30 so it was a mad rush for approval and booking surgery.

I guess the moral to that story is look into it sooner than later incase you have hoops to jump thru.

I used Dr. Fodero in Florham Park, he has been awesome..  

Stella

I have blue cross Blue Shield and it did not cover any of my plastic surgery.  I was fortunate to have lost 110 pounds with my gastric bypass, but did not have any skin irritations or breakdowns of any kind.  I still felt it was the last phase of my journey to have the excess skin removed so I went for it.  I used Dr. Joseph Fodero as well and he is an awesome surgeon and a really great guy.  He has a beautiful new office and surgical center in Florham Park NJ, but I had my surgery with him at Morristown Memorial.  His staff is really great and extremely helpful.  I would highly recommend him to anyone looking to "finish the journey!"

They have financing available and he stands by his work.  Plastics is really body art and he is a great sculptor!

Pat

Hi Pat,

You told me he was great and you were right, he has been awesome. His office is beautiful and his staff is so nice, all the girls are so sweet ~ they really make you feel comfortable even when you are having difficult things done (like the lovely pre-op pictures). So, Pat thank you. I had completely forgotten who it was who had told me he was great. 

I had my surgery two weeks ago (on 12/30) so today I went in for a post op visit and I had to have 600 cc's of fluid drained but I feel much better now that it is gone. I am looking forward to having the swelling gone and getting back to normal.

Have a great weekend, sorry for hijacking the post but I had to say thank you to Pat.

Stella