Should I bother trying to get Aetna to pay for a TT?

Should I even bother asking Aetna to pay for a tummy tuck?  I have a letter from my PCP which states getting a TT would help me sustain the loss and increase exercise - reducing the chance of my pre-WLS medical conditions to return.  Two of the three surgeons I've seen don't even bother trying to get insurance to cover the surgery.  The other inferred that I needed to show the medical necessity by letting myself get a rish in the apron fold.

What do you think?

As far as I know (and I may be wrong) insurance will not pay for a tummy tuck. They will however often pay for the panni removal. You can upgrade to the tummy tuck for the difference in cost though.

I was approved for a panni by my insurance and have never had a rash. I guess I met their requirements by the amount of my weight loss and amount of skin, which honestly for me isn't much.

Personally, I think it is worth a shot. You can lose anything by trying.

Martha

What have you got to lose by trying?  Even if they only pay for the panni, that should help some with the cost, and you just never know; you might be pleasantly surprised.  My insurance (Tricare) is covering the full TT, so sometimes miracles happen, lmao!

It doessnt hurt to try however it depends on your policy. Alot do not cover it. Some only cover the panni, but it will help with the cost  of the tummy tuck. You need to show rashes etc to get the panni covered with some insurance companies.  I have been plastic full of but  money less.
Policys didnt cover anything not even the gastric bypass.  Good luck.
                                                                                                                              Gail

Link to AETNA's policy on abdominoplasty at bottom of page plus tips for getting coverage:

http://www.drlomonaco.com/plastic-surgery-patient-resources. shtml

Thank you for sharing this information!

Thanks Dr. L for the links in your website and article. I'm using them to try and get Anthem BC BS to help pay for some of my upcoming surgery.

Diana

PS. I'm staying in the US and having my surgery done in VA.

Keep us posted on your progress, and be sure to explain to your baby in the pic there that you wont be gone for long. (S)he looks pretty concerned already.

That's Max, my grand baby! I have seen a Dr. KriegeL here in VA and also going to see a Dr. Bautista in Fredericksburg VA as well as your buddy from your military days, Dr. KriegeR. Much confusion here in the local area due to one letter difference in the surnames. I'll keep everyone advised as things develop.

Diana

PS I would add a pix of myself if I could ever figure out how! Max was a pup when I took that picture and is now 4 years old.

I am scheduled for my TT in Jan.

I sent a letter with all sorts of back up to Aetna - and asked my PS to submit approval for the Panni portion

per Aetna's policy document they will only cover the Panni - if medicially neccessary -- I have the rash and the back up from my primary doc - so we'll see

Aetna is quick (2 weeks or less) on getting back so I'll know so

any little bit they pay will be better then nothing, eh