Insurance

Sorry I am being a royal pain.....I had my consult this week and now have a million questions.  The dr said that my insurance will most likely cover a panni but not a full TT.  She said she did have one patient who appealled it and it got approved. Any tips on how to get it approved? I do have chronic back pain as well as rashes, and creams and what not. I have a self-funded Independent Health plan through my employer

I am trying to get help with plastic surgery also and maybe you could help. I am interested in a pani, my insurance will pay for it but need to know what to do. They said as long as there are medical issues. Could you help me with that. I do have back pain and have had rashes, could you give me some more info please...

My dr had me bring in anything that documented my back issues and rashes.  I had to get office visit notes from my primary dr, neurologist and chiropractor for the documented back pain. As well as my prescription history from the pharmacy showing I have been prescribed creams and powders and office visit notes from my OB/GYN and dermatologist for the rashes. Hope that helps! This is all new to me too!

The probability of it being covered are slim, however, since you have a self-funded insurance plan there's a possibility it could work in your favor if the "powers that be" in HR or Corporate are sensitive and understanding of your situation.

Did your doc advise you what the cost would be to have the insurance cover the panni and you "upgrade" to the TT? That's what I did.

What was the difference in the cost, are you glad you got the TT.

 Completely satisfied and I paid $3,200 out of pocket to upgrade to the full anchor cut TT.

first, call HR and see if it is covered.  I missed that point in my long fight to get insurance approval, until finally somebody send it in writing to me:  excluded from health plan of employer.

I was DONE for about 2 years.\\

I saved up ever since, doing respite care on weekends for foster kids ( I am a licensed foster mom), saving on food, turning off the lights when not in use, down grated my Internet and cable, to the cheapest there is, (actually canceled cable, and got a dish for 20 bucks a month), got rid of my cell phone, and bought a trac phone (only need to upload $ 20 every 3 month to keep it on), heck, I even sold my dishwasher for $ 200, because I never use it anymore, to save money.

I got kind of 'cheap' lol, but now I am in the position to pay for my panni/TT/ and hopefully, if the surgeon feels like helping out a little, a muscle tightening :)

I wish you the very best, and hope that your employer carries it!!  Karin

Mine is covered if the correct letter is sent from primary care. Any help is better than nothing, and you gave me great ideas to save money! I am a nurse and can work alot of overtime to and that would help! You have me excited again!

I did get prices from insurance covering the pani and me being responsibile for the rest of the TT. If insurance will cover the panni I will be responsible for $3300.  If the insurance will not cover anything, I will be responsible for $4800 plus the pre-admission testing.  I am a nurse in the healthcare system that this surgeon uses so I think I may get a discount on facility fees too so that would make it even less.