Does anyone who has Kaiser know?
I have some crappy insurance with Don't Care, Inc., so I'm not familiar with Kaiser. But if it will cover surgery for WLS patients, then I think they should cover any reconstructive plastic surgery for massive weight loss.
You might want to post this question on the Plastic Surgery Board and they will probably be able to tell you the prerequisites for approval, like how far your pannis hangs and if you have documentation of any rashes. I hope you get approval!
Mary
You might want to post this question on the Plastic Surgery Board and they will probably be able to tell you the prerequisites for approval, like how far your pannis hangs and if you have documentation of any rashes. I hope you get approval!
Mary
(deactivated member)
on 1/14/09 9:55 am
on 1/14/09 9:55 am
Look on the Kaiser website and/or call them. They should have their policy documented for members to review. They are typically called clinical policy bulletins or coverage bulletins. Most clinical policy bulletins have specific criteria for excess skin removal that is usually not contingent on how the weight is lost but rather what types of physical issues the excess skin causes (rashes, infections, impaired mobility, etc). Most insurance companies consider reconstructive surgery after massive weight loss to be cosmetic although there are some that cover it. If they cover it, they rarely cover a tummy tuck but will instead cover a panniculectomy which is merely removal of excess skin with no muscle tightening and IMO, not worth even having if you don't add the muscle tightening. (but I will admit to being a perfectionist and for some, removal of excess skin is enough).
As Mary said, there's lots of information on the plastic surgery board.
As Mary said, there's lots of information on the plastic surgery board.
alot of plans only cover plastic surgery if they consider it medically necessary from what i've heard too. the way they determine that is if you get alot of rashes etc etc like under the excess skin where it would rub. i've heard the best thing to do is like go to the dr and get every single rash, sore etc etc documented.