Aetna POS and cosmetic surger

Hey there,
I'm 9 months out after having RNY. I've lost 80lbs and have about 15 to go. I'm 51 and I never thought I'd consider plastic surgery. BUT...I finally had the courage to look in a full length mirror naked and I wanted to cry. My thighs/butt look like deflated baloons. I knew they would be saggy...but I didn't know to what extent. I'm horrified.
I have read that some insurance companies have paid for certain cosmetic surgery if you add'l skin hangs too low, skin rashes, etc. I don't have that issue so I figure I"m out of luck...but thought I'd put it out there. Has anyone had their surgeries covered by insurance? I don't even care about a TT but I'd LOVE to have my thighs lifted! I exercise but this is BEYOND what exercise can do.
Thanks for any info you all have.

I just had my consult today with a PS and she told me Aetna would not pay for my breast lift and TT.  There is a calculation they do for surface mass and weight etc.  I have had skin rashes and lower back trouble and she still doesn't think they will approve me but she is willing to write th letter and try.

FYI-

Lisa O.

I have Aetna and it does not pay for anything they deem as cosmetic surgery, so a thigh lift is a no go  ... They approved me for a panneculectomy which I'm getting in two weeks and I'm paying the difference for a full Fleur-de-lis tummy tuck. For me it didn't take much to get the first part approved, just have your doctor document some skin rashes over a period of I believe 3-6 months and that's all they needed. I hope that helps! I have baggy thighs too so I know what you mean!

I'm just curious, if you don't mind posting, what will your cost be? I think I may have success at a panni, but wondered what the cost for TT might be.

Thanks either way!
Heather

Aetna is very firm on the cosmetic surgery policies.  Panniculectomy is the only thing they will cover UNLESS you have a hernia and can get the TT done at the same time as the hernia repair.  There is no medical necessity for a thigh lift.  I had documented rash problems in my armpits (including photos) and they refused to cover any portion of the brachioplasty.

Lora

hi there, I just got approved (by Aetna)  today for panni and hernia repair.  Does that mean I could get a TT?  How do I go about doing that? Or does the surgeon just do it?

You can have the surgeon do it (I have heard RARE stories about the surgeon throwing it in for free), but the extra surgeon's time, operating room, and anesthesiologist expense will have to be paid by you.  The advantage is that it will cost you MUCH less than having a TT done separately!

Lora

Aetna sucks.

I just came from my first consult and what everyone else has been saying is correct.

They don't pay for nothing.

Part time job, here I come!

Can I ask which version of Aetna yall have (that have replied)?  I am 16mos post-RNY and starting to look at procedures.  I am pretty sure I need a LBL (lots of extra baggage in the back  LOL).

I have the Federal Aetna Open Access HMO.  They have been pretty good about paying for stuff - but I looked up what they had to say in the literature about this and it is very vague.  Bsically only says they will cover post-WLS if it is deemed medically necessary - but doen't say what makes it so...