Plastic Surgery is not an entitlement

Ok. I’m ready for the flaming   but I just HAVE to get this off my chest.
I hate hearing about people with welfare getting free surgery. It makes me want to quit my job and go on public assistance too. I hate reading people pleading for money to help pay for surgery. Save up, work hard or do without! If your insurance denies you for plastics and you can’t afford it, don’t act like it is a friggin entitlement because it isn’t. I work as a state employee and am in debt up to my eyeballs. I look like a melted candle but my insurance has a specific exclusion for plastics of any kind for any reason – the same for WLS (which I saved up for two years in order to afford – I worked an extra part-time job, did without new clothes, restaurants and cable TV). I work so very hard and still don’t have enough to combine with my available credit to afford plastics. But somebody once told me that in this county, everybody is free to WORK for the things they want and WAIT until they can afford them. When did this change?

I know people (IRL) who have bragged about how they are on welfare and found out how to work the system to get WLS and plastics paid for... So for the most part I agree with you.  I can see if it's medically necessary, and in some cases it is.  I mean if the reason they're on welfare/disability is because of their obesity and WLS will help get them off of disability - great.  

You are correct that plastics is not an entitlement.  My insurnace has a similar clause for plastics as yours (except ours does cover reconstructive due to breast cancer, etc).  DH and I met with my surgeon, got the estimate and DH poured through our budget, checked our credit, loan options - everything to determine what we needed to do for me to have plastics.

Bottom line - you can't always get everything you want, but if you have a goal and plan for it you stand a better chance of getting it.

Dear Miakawa:

   You sound very young, and very angry...either one of those conditions can lead you to say things that, later on, you might feel differently about.  For many individuals, removal of skin is a medical and not a cosmetic issue.  Insurance covers medical issues, and we wouldn't criticize an individual for wanting, say, a broken bone set.  You wouldn't say "hey, quit complaining and wor****il you can actually afford to get the bone set."  We don't ask people to do without medically necessary procedures in this country because they can't pay for them.....and neither does almost any other country on earth.  People who have lost considerably more than 100 pounds, especially after being obese many years and especially when they are older, are faced with mobility issues, skin infections, back pain, and many other medical issues because of excess skin.  The surgeries they seek are not making them cosmetically perfect, but merely allowing them to lead normal lives.  If there is no medical reason for the surgery, it should not be covered. 

   Being judgemental is a slippery slope indeed.  I have lost 140 pounds through diet and exercise..I never had bariatric surgery.  It might be tempting to judge you or others who had weight loss surgery as lacking the willingness to WORK (as you say) for weight loss.  But that would be ridiculous....everyone is an individual, and every individual needs to come up with a plan for their own life and health and work it.  And every person, bariatric surgery or not, looses the weight the same way...one pound at a time, through less food, more exercise and grace of God. 

   I have plastic surgery scheduled for 6 weeks from now with a very good surgeon.  I am lucky in that I can afford it, although I am still trying to get my insurance to pay some of the bill.  I saved them a fortune on medical expenses and the expense of bariatric surgery, but they are resistant, as are so many insurers.  This is true even though I have a finding of medical necessity for the skin removal.  I would completely support any person who had medical skin issues for making a claim for such issues, whether under private insurance or under a public program, such as medicaid.  (Luckily, we don't ask the poor to deal with substandard medical care just because they cannot pay.)  Those who have lost weight and are brave enough to take on the pain and recovery issues of skin removal deserve your respect and compassion, not your judgement.  I pray that some time and maturity may lead you to treat others on this forum with a greater degree of respect and kindness and I wish you luck on your journey.

NMFlame

not young (my avie is a very old pic) but admittedly angry. I'm tired of paying high taxes to support people I don't know. If I wanted to support other people, I'd give to charity. Taking money from me to support others is tantamount to legislating morality since charity is a moral value. Why should anyone have to pay for the expenses (food, medical care, housing, plastic surgery) for anyone else? Why should my taxes pay for someone to have plastics when I can't even pay for my own? Ridiculous.
And, you make it sound like skin removal is life-threatning. It may improve someone's quality of life, but let's face it, you know it is not medically necessary in the same way a heart transplant would be. Don't be absurd.

I agree with some of what you said....at the same time I fully understand why the original author posted what she did.  It can be very frustrating to shell out $$$$$$ while others are bragging about getting it free because they figured out how to beat the system.  I personally believe we each have to lay our head down at night and sleep in peace.....

ANYHOW.....I so love your comment  " have lost 140 pounds through diet and exercise..I never had bariatric surgery.  It might be tempting to judge you or others who had weight loss surgery as lacking the willingness to WORK (as you say) for weight loss.  But that would be ridiculous...."
I too lost my 195 lbs via healthy eating and exercise.  I work real hard when I post something so that I don't sound "stuck up" about my accomplishment...I am very proud of it but don't want to make anyone who chose to have WLS feel inferior in anyway. 

I also tried to convince insurance that I saved them a lot of money by not having LS and by getting healthy and eliminating my medical issues.... maybe I didn't fight enough but I've paid out of pocket.

I don't think comparing the medical necessity of having a broken bone reset and a Tummy Tuck is really fair.... but how about braces on the teeth.  Insurance covers to fix crooked teeth but not to remove the 10 inches of skin flapping around my arms....  oh well.

CONGRATS on your weight loss and Best Wishes on your upcoming plastic surgery.

Plastic Surgery in general is normally unless you have some documented medical issue is not medically necessary.  It is a nice to have.  I understand about the welfare system, but it is what it is.  My insurance will pay for my TT due to a medical issue.  You should be proud of how hard you worked for what you have, but needless to say life isn't fair.  There are some that get things for free while others dont. 

But the question is.... is it worth being up to your eyeballs in debt just for PS?  I won't go overboard just to make my body feel better.  I look melted myself, but I will never reach perfection at any time in my life. 

I still love to do things.  My motto in life is that I dont live to work, but I work to live.

I'm not going to flame you.
I totally understand the frustration of having to pay thousands and thousands of hard earned money while others brag about getting it for free.  However I do believe we all need to be at peace with our life decisions so who knows maybe some others are not getting a peaceful night sleep.

I've had to pay for all my surgery...it's taken a big chunk out of my retirement fund but at least I'll look pretty good

My grandmother always told me do not use a credit card for anything you cannot pay off in full the day the bill comes in.  She never had a credit card...if she wanted something she saved her pennies and then bought it.  My parents were pretty much the same.  I hate having monthly bills hanging over my head.

My grandmother always told me do not use a credit card for anything you cannot pay off in full the day the bill comes in. 

Grandmother is/was a smart woman!   

I agree that the issues raised by extra skin are not life-threatening....but neither are the vast majority of covered expenses under either private insurance or medicaid.  We don't tell people that they cannot have skin rashes (or arthritis, or back pain) treated because they are not life threatening.   There is such a thing as quality of life....and it is that quality of life we are protecting. Truth is, anyone who can prove medical necessity should be able to get surgery.....having as much as 20 or 30 pounds of skin removed may allow a person who was previously morbidly obese to return to the work force and leave public assistance.  I think we often underestimate the effect of extreme obesity on a human being...and on their ability to work full time and be their most productive.  We also underestimate the effect of carrying around a pannus that weighs 20 or 30 pounds after extreme weight loss.  The folks who are posting here...except for the original person...don't seem angry that someone qualified for the surgery under insurance or medicaid.  Rather, it is the unfairness of the unequal treatment that they experienced in not getting financial help with the surgery that is most frustrating.  I agree that this is unfortunate.  This unequal treatment extends not just to plastic surgery, but to weight loss surgery itself.  Why is it so arbitrary?  Why do some plans cover so much, and some nothing at all?  Why isn't there a clear policy and understanding on whether body contouring surgery is tax deductible after extreme weight loss?  Why do we make people jump through so many hoops when it is clear that morbid obesity is so dangerous and life threatening?  Why are these insurance companies able to do this (hint: you can't sue them, but that's another story.)  Until we have a more comphrehensive policy or even laws on all this, it will continue to be this arbirtrary.  I would rather have $30,000 in the bank myself.....but let's not confuse that with trying to take medically necessary care away from someone else.  Any time someone in this forum is sucessful, it is a victory for everyone else.  At least, that's the way I see it. 

Gail "NMFlame"

PS  Moosie.....I was starting to think I was the only non bariatric surgery person in this position.....its impossible to find good information anywhere but the WLS community, isn't it?  Congrats on your success as well....you should write a book. 

I have seen both sides of public assistance - there have been times (before I was born) that my parents needed to be on it for a short period of time) and there was a time after college when I needed to be on a medical card because I had no insurance and a severe back problem.

With my job, I have worked with a lot of physicians around the country who have told me they have patients as young as 16 who do everything they can to end up on disability because they think "that's living the life."  I kid you not.

I also know families who look for every possible means of help without having to go on welfare because they don't think should take from others.

There is a balance - public assistance is needed.  And I don't have a problem paying taxes for it as one never knows when one may need the help.  It's not a pure black and white issue... it's mostly a huge field of grey. 

Like I said, if the surgery is something that will help someone get off of disability then that's great - it's a win win for everyone.  Does it frustrate me to know there are people taking advantage of the system rather than putting that same effort into finding away to contribute to making the world a better place?  Yes.  But right now, I can only worry about me and what I contribute to the world.

The fact is, no matter what program is in place, as long as people are involved someone will always look for a loophole.  Always.

Edited to add - I'm suspecting that the original post stemmed from another one.  In which case, a direct approach might have been better.  Although, maybe not as it is a sensitive issue.