UHC Insurance - anyone have experience in PS coverage

(deactivated member)
on 9/16/09 10:29 am
Hi, I'm Sharyl, originally from Chicago and now in Los Angeles for four years. I had my gastric bypass May 2002.  I had my panni removed and my arms had a first stage of surgery done. I need a lower body lift (including upper abdomen), boobs (no implants, just skin removal and lift) side boobs, remainder of arms, back. I have UHC at work and have no idea where they stand on PS. Of course, I assume the worst, that nothing will be covered or maybe, maybe just my upper abdomen. 

I don't have rashes or anything like that to document, any body pain related to the excess skin. But it's a LOT to lug around - my panni removal weight 21 lbs, and that was just one body part.

I will research the archives here, it's been five years since I've done any PS research and things have really changed, can't seem to find specific groups, info by state, insurance company. Any insight you have would be great. 

Thanks,
Sharyl
# 1 MACK_MAMA
on 9/16/09 9:45 pm
I had my TT covered under UHC as a scar revision from my panni removal.  But haven't seen anyone get anything more than that approved - and it depends on what riders are in your policy specifically - so you should call UHC and ask

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Monica P.
on 9/17/09 4:06 am - Long Beach, CA
RNY on 07/19/07 with
Every policy is different...but I had my lower body lift covered by UHG. I had to prove "medical necessity".  They were stubborn, and I had to appeal after I was denied at first. I had to consistently document rashes for months, include photographs and had a letter written by my primary care doctor.
(deactivated member)
on 9/17/09 4:15 am
Hi ladies, thanks both of you for the feedback. At least gives a bit of hope.  I thought it would help to have some idea of what I might be up against before I started the process. I'm trying to figure out other avenues of medical necessity since i don't have rashes.   I'm sure I have a chance at the LBL/TT, doubt we can ever get them to cover arms, boobs, back. But I'm going to give it a shot, and at the very least, check back with my plastic surgeon in Chicago, because I think he owes me one for that awful nurse. She was moved into a different area in his office not long after my surgery because she botched so much paper work.
Monica P.
on 9/17/09 3:47 pm - Long Beach, CA
RNY on 07/19/07 with

In my situation, the other criteria (that I did not totally qualify for) was functional impairment. If you can somehow prove that you have your movement impaired by extra skin you might have a chance.

Good luck!

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