How long after WLS ...

My insurance approved me (today, in fact!) for a panniculectomy.  My insurance (Harvard Pilgrim) requires a weight loss of 75 lbs or more, at least 18 mo post op and maintain stable weight for 12 months.  I am paying out of pocket for an additional procedure (tummy tuck)  My insurance is paying for the pannic for documented skin rashes and boils and scars from those issues.  I will be 24 months post op on June 25 and I started the process for PS in January.  That is when I had my consult and found out that I needed to have the 12 months stable weight.

Hey babe, this is what my insurance requires for a TT and i have bcbs too (different state tho but yours is probably similar):

Description: 
 

Abdominoplasty involves the removal of excess skin and fat from the pubis to the umbilicus or above, and may include fascial plication of the rectus muscle diastasis and a neoumbilicoplasty. It is most often performed for cosmetic purposes and may be performed at the time of a panniculectomy.

Panniculectomy involves the removal of hanging excess skin and fat in a transverse or vertical wedge, but does not include muscle plication, neoumbilicoplasty or flap elevation.

Policy: 
 

Panniculectomy, with or without abdominoplasty, may be considered medically necessary when the following criteria are met:

• The pannus/panniculus hangs at or below the level of the pubis; AND
• The patient has maintained a stable weight for at least six months; AND
• If the patient has had bariatric surgery, he/she is at least 18 months post operative; AND
• There are rashes associated with the pannus/panniculus resulting in cellulitis or ulcerations

Panniculectomy, with or without abdominoplasty, is considered not medically necessary when the above criteria are not met.

Panniculectomy and abdominoplasty when associated with bariatric surgery is considered cosmetic if the above criteria are not met.

Panniculectomy, with or without abdominoplasty, may be considered medically necessary as an adjunct to a medically necessary procedure when needed for exposure in extraordinary cir****tances.

Panniculectomy and abdominoplasty are considered not medically necessary when performed primarily for the treatment of neck or back pain.

Panniculectomy and abdominoplasty are considered cosmetic when performed primarily for ANY of the following:

• Improving appearance
• Repairing abdominal wall laxity or diastasis recti
• Treatment of psychosocial complaints

Suction-assisted lipectomy is considered not medically necessary.

You guys are wonderful!! Thanks so much Sooner, you already know you rock ;)