Metroplus/Medicaid For Reconstructive Surgery

Hi All, I'm new to this forum. I've recently lost alot of weight without sugery,( no offense to anyone). I'd like to know if anyone would know if I can have some surgery covered by my insurance, as I'm having a few medical probs....massive back pain, chafing and boils under folds in breasts, stomach and inner thighs. (This is my 3rd and final time losing this weight...I started gainig after my only child 15 years ago. I tend to go up and down 60-70lbs. I've finally made a complete lifestyle change...no more crash dieting. I think I'm doing well....smile. For the first time ever, I'm doing the positive weight loss...proper diet nd exercise. I hate this yo-yo diet thing. Needless to say, I have loose skin on my stomach, sagging breasts and thigh rubbing/chafing...(always had that), that's causing me to be less mobile as I'm always in pain for one reason or another. I'm still on my quest to lose another 25 lbs, however. The only thing is I'm losing weight differently now as I'm getting older...34. The areas that once bounced back into shape are no longer on my side...literally. I'm doing my own research online before proceeding further with my PCP. My doctor has given me a referral to a dermatologist for the boils and chafing. I figured I'd talk to the derm about the surgery. I'm also going to see my chiropractor...not covered by insurance, for spinal manipulation as well as to ask him to write a referral for the necessary surgeries I NEED...more then want. This is getting unbearable. The boils are disgusting and back pain,( I have a deep arch in my lower back that's being thrown out of whack due to the pressure from the hanging stomach and breasts), has become a part of my everyday life for the past 6 years. Can anyone give me and advice or past experience with this particular insurance ? Thanks for your time.

Kristle: You are wise to have documentation of medical necessity. Unfiortunatley most insurances are not easily swayed to perform any PS, a panniculectomy *removal of apronof skin in front) and possibly a dreast reduction may be covered. The only way to know is see a Plastic Surgeon (WHo is familiar w/ post huge wt loss body contouring/reconstruction) and appeak any denials! Look to the OH PS board as well for more advice ok! http://www.obesityhelp.com/forums/plasticsurgery/ and these are some other wls + PS sites, I'd recommend losing that 25# and being stable 6 months before having PS. I wish you well on maintaining, I know losing wt is easier than maintaining even w/ WLS I was never able pre WLS to do it w my 100# wt loss 3x. So far 4 yrs out I am holding w/in 10# Be well, and hope you beat the statistics! http://health.groups.yahoo.com/group/GastricBypass-PlasticSurgery/ http://groups.yahoo.com/group/WLSandPlasticSurgery/ http://groups.yahoo.com/group/ossgplasticsurgery2 Take Care, Jamie Lap RNY 10/9/02 Dr. Singh 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King http://www.obesityhelp.com/morbidobesity/members/profile.php?N=c1132518510 "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"