Insurance coverage??

So, does insurance ever cover, or help cover plastic? If so, what generally do they cover and how do we get them to cover?

I need help, I am just starting this journey, I could use all the advice you can share. Thanks.

It's different for everyone.  Some will say it depends on skin infections/rashes, how much your panni hangs, etc.

Really, you have to go check with your HR or insurance people to see what is covered in your policy.

My company's policy specifically excludes plastics unless it is for reconstruction following breast cancer.

Your company should have the policy available to you, if not either contact your HR rep or call the number on the back of your insurance card.

If it is covered, then you need to ask the insurance people what you need to have your doctor provide when he/she files.

Generally, if any insurance is going to cover anything at all-it is going to be the breasts and / or the panni.  That is usually about it.  That is of course due to how much documentation you have, your individual policy, if you are having any back problems etc....

Best thing is, if you are having any problems, issues at all-start documenting them by going to the drs, getting prescrips, taking pics of rashes etc....

Debbie

I was quite shocked to find out that my insurance approved my tummy tuck, which is going to happen this coming Monday!  I'm having a "fleur-de-lis", also known as an extended tummy tuck.  The stipulations were 100 lb weight loss and evidence of rashes/skin issues.  I started documenting skin issues the first year I was postop RNY (3/12/2007 was my surgery date), both with my bariatric surgeon and my primary care physician.  I went for my plastic surgery consult on 6/01/2010 and was approved on 06/21/2010!  The plastic surgeon's office was shocked, as was the hospital.  I have to pay a $200 hospital deductible preop, and when I talked to the lady there to pay that she said they are going to have me sign a waiver that I'm responsible for the bill IF anything happens and Medcost doesn't pay.  She said they have the approval letter, just like I do, but that in the 11 years she has been doing this job, that mine is the FIRST she has ever seen approved -- however, she did say that she has never submitted a claim to this insurance company (Medcost).  But I called Medcost when I got the word from the plastic surgeon's office and said "is this really approved?" and I was told yes, indeed, it was a go!  

Aloha- Check with your insurance company's policy on plastics- they are very specific ( mine covered panniculectomy/muscle tightening if the pannus hung below the pubis, with recurrent rashes/infections, or if you had lost over 150 lbs).
My advice would be to start with a consult with an IN NETWORK provider, have THEM submit photos and any documentation you have of recurrent infections, or back pain ( from breasts) from your PCP. If they approve, THEN choose your surgeon and resubmit- mine was covered with an out of network surgeon with a small deductible and 80% rather than 90% covereage- but I had already gotten approval with an in network surgeon so they couldn't very well say it was no longer medically necessary, could they?  I combined procedures ( circumferential lower body lift, whi*****luded the panniculectomy and muscle tightening as well as a butt lift, and the breast lift/augmentation) and my plastic surgeon had to note when the clock stopped on one procedure and started another . Insurance ended up covering about $8K of a $24K procedure with an out of network provider. I could have had it much cheaper by choosing - in network, or a lesser procedure like a simple tummy tuck- but I wanted the circumferential, and I wanted it done all at the same time. Good luck- XOLori

 I just had mine done two weeks ago - I had a fleur-de-lis abdominoplasty with a breast lift.

The only part my insurance covered was for a panniculectomy - which was around $3500 of the total charges.  They also covered the OR and anesthesia for that procedure, which also saved me a little bit of money.

My surgeon said it really varies by insurance company, and even though my policy excludes plastics - it's unless medically necessary (as in for reconstruction due to accident/injury/illness).  He took loads of photos, and I had well documented my own rashes and yeast infections through my own family doctor - along with photos I took on my own.

Good luck!

Thanks for the info :)  I am hopeful :)