Anyone in Virginia????

genifur2000
on 9/26/09 3:27 am - Lynchburg, VA

Hi Everyone...

I had gastric bypass three years ago and I am at a point (after losing 200 pounds), that I'm ready to consider plastic surgery. The primary issues that i have are associated with my lower body (tummy, thighs, hips). I have insurance that will cover plastic surgery if it is medically necessary and associated with weight loss surgery. BUT...here is the problem that I am having. I am having trouble finding a surgeon that will even deal with an insurance company. Every doctor that I have talked to considers this to be elective and charges accordingly. Has anyone had success finding a doctor (I live in southwest Virginia...but I'm willing to travel for a good doctor) that accepts insurance for a thigh lift/tummy tuck. Thanks for any imput and I wish everyone great success on their journey!!!

Jenn

Jupiter6
on 9/26/09 9:09 am - Near Media, Pa- South of Philly, NJ

RNY on 07/16/07

It's got little to do with your surgeon, although some just can't be bothered-- really it's YOU who has to find out what is and what is not a covered benefit under your insurance, and you who has the burden of proving medical necessity. Many will accept insurance provided you have done the legwork and made a very good case for medical necessity.

Your pannus may be covered, but abdominoplasty rarely is, neither is thighplasty, generally, unless you can prove it's medically and not just cosmetically necessary. In my case, it knocked $3k off of a $18k bill, which is a nice coupon, but not much else, and I had literally dozens of photos and records from 5 doctors and surgeons of rashes, sores, boils, skin degradation, copies of prescriptions, etc.

Please, check out my stuff and give my surgeon a call. He's in VA Beach-- not exactly nearby , I know-- but you really cannot find a better guy. Info is in my signature. I'll add you as a friend so you can see my photos.

"Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert Lap RNY 7/07-- Lap Gallbladder 5/08--
     Emergency Bowel Repair 6/08 -Dr. Meilahn, Temple U.   Upper and Lower Bleph/Lower Face Lift
     12/08
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA Mastopexy/Massive
     Brachioplasty/ Extended Abdominoplasty (plus Mons Lift and Upper Leg lift) / Hernia Repair
     6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10 - Dr. Ivor Kaplan VA Beach
     Total Cost: $33,500   Start wt: 368   RNY wt: 300 Goal wt: 150   Current wt: 148.2 BMI: 24.7

1stlady
on 9/29/09 6:10 am - VA

Lap Band on 06/13/08

Hi, Jupiter

I am also in the same boat haveing a hard time finding a PS that will excepy my insurance but I know that for sure my abdominoplasty will be covered fully.. I am in VA did the surgeon u went to accept insurance...

CW 319/ I can do this.....22lbs till goal ( I WILL NOT SABOTAGE MYSELF).....

Jupiter6
on 9/29/09 1:32 pm - Near Media, Pa- South of Philly, NJ

RNY on 07/16/07

Yes, my surgeon accepts insurance and is part of my plan.

Why do you believe you will be covered fully? You really cannot know that until submitted by your surgeon.

"Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert Lap RNY 7/07-- Lap Gallbladder 5/08--
     Emergency Bowel Repair 6/08 -Dr. Meilahn, Temple U.   Upper and Lower Bleph/Lower Face Lift
     12/08
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA Mastopexy/Massive
     Brachioplasty/ Extended Abdominoplasty (plus Mons Lift and Upper Leg lift) / Hernia Repair
     6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10 - Dr. Ivor Kaplan VA Beach
     Total Cost: $33,500   Start wt: 368   RNY wt: 300 Goal wt: 150   Current wt: 148.2 BMI: 24.7

1stlady
on 9/29/09 10:13 pm - VA

Lap Band on 06/13/08

Thanks' the reason I said that is b/c with my insurance as long as I lost 100lbs which I did and maintain it for 6 months which I have then they will pay for your tt any other things have to be MN.....

caroline2622
on 10/4/09 6:25 am - Woodbridge , VA

VSG on 09/30/08 with

From what i understand BCBS is one on the few insurance co.'s that will pay for PS WITH well documented medical reason. ie heavy rashes. Sad part is they will not pay for assisting with back pain.

lost 140 lbs

Extended TT 12/072009 Plastic Surgeon Mitchell Krieger

Jupiter6
on 10/4/09 6:38 am - Near Media, Pa- South of Philly, NJ

RNY on 07/16/07

Unfortunately, there's no such blanket rule. Everything's decided on a case by case basis and can be pretty arbitrary so you CANNOT bank on it. I too have BC BS-- a very high tier version to boot!

I have 5 years of photos of itchy, bleeding, oozing sores and rashes, all dated. Letters from 5 different physicians including a dermatologist, PCP, plastic surgeon, bariatric surgeon. I have Hydradenitis Suppurativa-- a skin condition that makes large oozing and painful lesions. Copies of prescription and non-prescription medications I have taken.

Still, mostly not covered.

"Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert Lap RNY 7/07-- Lap Gallbladder 5/08--
     Emergency Bowel Repair 6/08 -Dr. Meilahn, Temple U.   Upper and Lower Bleph/Lower Face Lift
     12/08
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA Mastopexy/Massive
     Brachioplasty/ Extended Abdominoplasty (plus Mons Lift and Upper Leg lift) / Hernia Repair
     6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10 - Dr. Ivor Kaplan VA Beach
     Total Cost: $33,500   Start wt: 368   RNY wt: 300 Goal wt: 150   Current wt: 148.2 BMI: 24.7

caroline2622
on 10/4/09 6:52 am - Woodbridge , VA

VSG on 09/30/08 with

Thanks for your insight. I have a (2) small hernia's to be repaired and going in for a front & back lift. I am documenting rash issues, hoping they may pay for the front lower lift. Know they will not pay for the rear lower lift. Figure on paying for at least half of the surgery.

Have a supportive bariatric and PS. Will see what happens

lost 140 lbs

Extended TT 12/072009 Plastic Surgeon Mitchell Krieger

Anyone in Virginia????

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Anyone in Virginia????