Thighs DENIED!

Just heard from Blue Cross MA, that although my Panni is covered, my saggy baggy gross thighs are not because there is no "medical Necessity" for it. So I suppose I will have to appeal it. This time with a letter from my PCP stating rashes, raw skin from rubbing together, infection that need antiboitic to treat, etc....

Not letting this get me down, I cannot afford to self-pay, and my credit is way too bad for a loan or credit line! So I will appeal, and we shall see what becomes of it.

Dawn

Dawn,
Let me know how that goes. I have Anthem PPO and I'm on my way to a TT within 2wks.
I would love to get a thigh lift too. We are in the same boat.

Keep us posted.

I have Anthem PPO as well.  It took 3 appels before they covered the panni.  I didnt even bother with trying for the thighs 'cause I want to use a private surgical center.  Good luck!!

April

WOW! Well that must vary.

I was not denied at all with trying to get my TT. At first I was with one surgeon and I got approved. In the meantime, since sergeon #1 was taking a long time to submit my file to the ins. I went to Surgeon #2 and I was approved 4days later.

After TT, I plan to go for the BL and thighs. You never now.

Dawn,

I have BC/BS Federal & was denied twice for my thighs.  The last appeal I had two physician statements and a letter from a physical therapist stating the excess skin on my legs was causing balance issues and they denied for the same reason - no medical necessity.

What gets me is how can you have 2 doctors telling them it's a medical issue & they come back & say it isn't. 

I had posted previously about this frustration & Dr. Lomanico (not sure if I spelled it right or not) responded & said he rarely saw thighs approved.  I just needed to know if they ever were or was I just beating my head against a stone wall. 

I went ahead & got my panni removed, TT & BL/BA this month (only the panni was covered by insurance) & my PS said she would try another attempt at getting some of the leg skin removed by insurance. 

Good luck!

Patty

I have Anthem BCBS PPO of California and they approved my arm lift but denied my thighs as well.  I have gone on many, many consults and have heard the same thing over and over again.  They very rarely see the thighs get insurance approval. 

Wishing you the best....maybe you'll be one of the lucky few.

Ya, they approved my brachio and breast lift on the first try..and they weren't even as bad as the panni!  You never know with these insurance companies

April

You are right on with what you need to do to appeal.  Just be sure to be able to have your PCP document dates you  saw him with rashes etc., for the thighs and all health issues, keep copies of pescriptions and receipts showing they were filled.

Pictures are also great.

Jim