How to get insurance to pay for PS, and the last 30 lbs questions

Hi All,
I am 10 months out on my DS.  I'm at about 83% of EWL.  I am starting to think about plastics since I'll need to start thinking about the cost.  I know that I've seen some people get approved for surgeries.  I don't look too, too bad and I'm not too picky.  I'm 43 and not looking for perfection. 

I definitely need my stomach or a LBL done.  My breasts and arms (and the area between them) are not looking great but I'm on the fence on getting them done or not.  I'll see how they look as I lose the last 30-40 or so pounds.  My inner thighs aren't bad at this point. 

Anyway, my question is what would help me get some of these done by insurance?  I have BCBS of Illinois even though I live in California.  I see breast and TT surgeries covered the most but how have arms been covered too? Is it too late to start with complaining about "rashes".  I really don't have any yet. 

Second question is how much difference did you see in hanging skin on the last 30 lbs?  Was most of your skin issues from the early large weight loss or more towards the end?  I have lost 120 or so and need to lose up to 40 more.  I'm 5' 2" tall. 

Thanks everyone.  I'll be spending more time on this board going forward. 

Cheers,
Cathy

Cathy-
In most cases you will have to document medical necessity to get insurance to cover.  You might want to look at the articles Dr. Lomonaco has on his website about getting insurance coverage.  Look under the patient resources tab.  http://www.drlomonaco.com/index.shtml

It's hard to say how much more loose skin you'll aquire with more weight loss but it will happen. Getting plastics too soon or getting them and then losing more weight afterwards can significantly change the results. Just another thing to keep in mind. Most plastic surgeons want you to be at a stable weight for about 6 months before starting plastics.

I'm 5 weeks postop anchor tummy tuck, and my insurance company paid for it.  I do not believe they will cover my breasts/thighs, however they had no problem with the tummy tuck.  It was $200 for me (hospital deductible), and the remainder was over $19,000.00 (just saw the bill this week).  I'm SOOOO thankful they covered it!  It took a lot of documentation from my bariatric surgeon, primary care physician, and plastic surgeon, but they approved quickly. 

Regarding how much more loose skin appeared the last 30 lb or so, I'm sure there was more but it isn't something I can really remember stood out.  Pics are on my profile of my recent surgery & progress, though!

Best wishes!

Wow....I looked thru your whole photo journey!  That is an amazing transformation.  I weighed almost the same as you for my starting weight.  To imagine a possible size 6 and a flat tummy is hard.  I am very scared of PS so I was glad to see you camping one month out!  :)

Was your major problems rashes?  I do have some chronic back aches from the tummy weight but I have nothing documented to date.  Thanks for your reply.  This is very encouraging!

Cheers,
Cathy

Your best place to start is with your insurance policy.  Two employers can use BCBS however, the policies can be very different.  The policy is written per negotiations with each company and what the company wants to include/exclude.

Find out what is in your policy and see what they require for documentation.

Cathy, fancy seeing you here!

PM me your real email address if you like and I can send you my BC/BS of IL letter and stuff. They paid for my extended TT in late June. They would not do my arms and boobs, so I just self-paidf for my arms.

Nicolle

Can you believe it's already that time to start thinking about plastics?  Geez....where did the time go?  How has your healing been going?  I remember thinking how great you looked on your first post after PS.  I can only imagine how great it looks and feels now.  No regrets? 

I'll PM you my info.  Thanks a million! 

Time flies when you're getting skinny, huh?

My healing is going well. I am six weeks out. I feel pretty good, some minor swelling at the end of the day. The scars are less bloody-looking. I have newer pix on my blog.

No regrets so far. My doctor needs to tidy up my belly button because it is healing in a weird way, getting wider. But that will be in a few months.

Nicolle

I Just got approval for Tummy Tuck and I have the same insurance that you have. First pull ur policy from the BCBsil website. You have to show documentation of a rash or skin irritaition that is documented by a dr. you also have to show that you are trying to treat it with.. Ointments and powders and that it keeps reoccuring. Also your pannus has to hang to or below your pelvic area. The other criteria if you don't have any of those are that you have a hernia. I submitted my information with 2 doctors visits to my primary dr. That documneted i had loose skin and prescribed mne powder. Then in the mist of it all we found out i had a umbilical hernia and she referred me to a surgeon. I submitted paperwork on 08-25 which they lost, Then i refaxed additional documentation on 09/03 and i called them every day. I got a phone call today with my approval.