Will insurance ever cover TT?

I am just starting my research on abdominal surgery.  I had Lap RnY one year ago.   I have lost 100 lbs, but my stomach still protrudes as if I am 9 months pregnant.  I don't know if maybe I have a hernia?  I was wondering if insurance will ever cover a TT or panni removal?  I definitely need my ab muscles tightened!  I can't afford to pay for surgery myself, so if anyone has any advice, I would greatly appreciate it.   Thanks, Marcia

Marcia, I just got approval for an abdominoplasty through BC/BS of IL.  My plan was very clear on what it needed to cover abdominoplasty, so I just followed it to the letter. I would start your process by contacting your insurance company and getting your requirements/see if they cover it.

FYI, for a year, I chronicled my skin issues with my PCP in his notes and photos. My PS took my materials and sent them in with his own notes and recommendations.

You could have a hernia, which could help you get some of your TT's costs covered if you do them simultaneously (anesthesia, hospital stay, etc.). Get that checked out. You may have to pay for the TT yourself, which might be do-able

Good luck!

Nicolle

Congratulations on your approval! I got my approval letter today. I got a denial letter on April 6th and then my surgeon called BCBS of IL on May 6th and spoke with the review board. My decision was overturned and received my approval letter today. My letter states I meet the medical necessity for panni and abdominoplasty.
I know this is going to sound dumb but............when I went to my surgeon and we discussed this he said with the panni approval that for $400 out of pocket he could do the upper ab tightening (his patients are only weightloss surgery patients) and the belly button repositioning would be considered cosmetic with panni and would not be covered by ins. So, for $700out of pocket  he can do this too or as  a lot choos I can opt out for belly button.
My question is that since I got the approval letter for abdominoplasty then wouldn't the repositioning of belly button be done with this approval?
Will your upper ab also be tightened?
I was planning only on panni and now I need that I get more I have to figure out what it is I am getting. Can't wait fo rmy appointment!!
I haven't got to speak with him about this. I go May 18th for pre-op and have surgery May 20th.

Hmmm...I would think the abdominoplasty approval would cover the tightening and belly button. Worth asking your surgeon, for sure.

Congrats on your approval.

Nicolle

Depends on your insurance.  I have Federal BCBS which stated they DIDN'T pay - but I made an appt with a participating Dr, went for my consult and he said they would - and they did.  Paid for the panniculectomy and I upgraded to a full TT, which is the anchor cut with muscle tightening.

Find out from your insurance if they pay.  If so, find a Dr who takes the insurance and get a consultation.  Even if they don't find a Dr that participates - you never know.... but be sure he's a good surgeon who is experienced with weight loss patients.

It depends on how your policy is written.  My policy specifically states that it does not cover plastics, unless it's part of a reconstructive process, such as breast cancer surgery. 

I'm also going to have a hernia repair and insurance will cover that, but the anesthesia is being included as part of the plastics and not the hernia, since the plastics are the reason I'm going under in the first place.  I suppose if the hernia was the primary reason for the surgery then it would be different.

Good luck in getting it covered.

I have BCBS MI and my full TT was covered.
First step is to call your insurance and see what the requirements are.
Mine were:
1) has to be reconstructive in nature and not cosmetic.
2) I have to have a documented weight loss of at least 100 pounds.
3) I have to have uncontrolled intertrigo (use of topical agents, alcerations) and/or lower back pain.
4) at least 6 months have passed/weight has stabalized.
5) $500.00 deductable per person.
6) 20% copay
HTH

IF you have a hernia, you have a good chance of getting at least part of it covered.