Surgeon wouldn't even request approval from insurance.

 I went in for my second plastic surgery consultation today.  The surgeon was all for doing surgery on me and said I met the criteria to have it approved by insurance.  But upon his examination, he said, "Nope, you're not a candidate."   Apparently, I don't have ENOUGH excess skin.  He wouldn't bother to bill my insurance.

I simply cannot afford $20,000 for the amount of surgery I need.  

I'm broken hearted.  

what are you trying to have done.  I would check with another plastic surgeon.  Also, you can ask your insurance what the critera is and then check and see what your doctor's plan is.

You might try another surgeon who is at least willing to TRY.

One of the things I found is that, even though my insurance approved my panni removal, NONE of the plastic surgeons in my area (except for one who had JUST opened his office and apparently needed patients!) will accept insurance for a panniculectomy... they claim it's cosmetic (even if insurance has ALREADY approved it as medically necessary) so that they can charge the patient the full-fee rather than taking the reduced fee from the PPO/HMO.  I got lucky... the surgoen who did my panni under my insurane now has joined in with all the other ones and no longer accepts insurance for it.  So it MIGHT not be a matter of you not having "enough" extra skin... it might be more a question of the surgeon wanting the full fee.

Lora

I know there are certain criteria that you have to meet for the insurance to pay and you hope that your plastic surgeon is trying to help you out in every way he/she can.  BUT...........Sometimes you get a doctor that just doesn't want to get tied up in the paper work and insurance companies because face it insurance companies don't like paying out money and will argue and do anything they can NOT to pay.  I think the doctors would rather you pay them then its up to you to fight with the insurance company.  I sit on the fence with this because i do work in the medical field and fight for insurance to pay us or I fight for and do endless paper work for our client and I don't charge for it which sometimes takes months.

I went for one consult and the ps said OHIP (Canadian Health Insurance Plan) would not pay for a panni.  I just didn't have the good feeling i think I should have had with the person i pick to do surgery on me so i went for a second consult and he said "I will do the paper work and let you know what they decide" They did pay for a portion of the panni ($500.00) which isn't alot but hey its better than nothing and I paid the rest out of pocket for my tt and breast lift. I had lost so much in losing weight i didn't have enough for a breast reduction  but lost of sag so did not qualify for that.  But more important i liked the way he made me feel like i was in good hands.  His scoring on MD's list were excellant and he put me at ease. 

Try another consult.............see what the opinion is.  Wishing you the best

Wendy

 This was the last plastic surgeon in my area that accepts insurance.  I went to the other one two years ago and was denied.  

I have severe rashes on my stomach and inner thighs, so I was trying to get a TT or panni removal, and inner thigh lift.  Basically anything I can get at this point...

Tell him to fight for you. I was supposedly a lost 'cause, but I insisted!

If not, find another surgeon.

I'm so sorry he won't fight for you. Tell him all he has to do is SUBMIT. Get together all your medical documents for the rashes, etc..., letters from your PCP, dermatologist, orthopedist, gynecologist, ANYONE and anything.

I had a letter from my therapist and documentation of rashes from my PCP.  I presented them to him and he said, and I quote, "That stuff won't matter, it's what I put in my report that matters." 

He refused to take pictures because he said there's no point, I don't have enough excess skin to be approved through insurance, but he'd surely discuss cost with me.  Having been through a few plastic surgery consults, I have a pretty good assessment of how much it will cost me, if I had that sort of cash laying around.

My area doesn't have a lot of quality plastic surgeons at my disposal.  This guy was the last of three that accept my insurance in my area.  I have already seen one of the others in 2007, and was denied then.  The other doctor is in the same practice as the surgeon I saw yesterday.

I even told this guy that I was so disappointed by the first experience with the other doctor in town because I felt like he didn't give a crap about me and that I was just another body to poke at instead of a person needs this surgery.  It seemed like the surgeon yesterday understood until the exam when he threw up his hands and said, "There's nothing I can do insurance-wise for you, but wait in the room and my biller will discuss cost." 

I'm just not sure what else to do.  I feel stuck.

You are as stuck as you want to be....spread out from your hometown if insurance permits.   See if there's a teaching institute that does it cheaper.   What about Mexico?  If I were on the West Coast that would be an option!   Good luck, you'll work it out.

I have looked into Mexico before so that's the other option I'm going to look into again. 

I'm just voicing my frustrations here, that's all.

I know.  It's very frustrating.  Keep at it, something will come up for you.  Wishing you lots of luck.