Health Insurance Coverage for Plastics?

I checked my blue cross blue shield coverage online and found these exclusions to professional surgery:

Exclusions

• Surgery - surgery for psychological, psychiatric or emotional reasons, cosmetic procedures and all related incidental services, and medically necessary surgery performed at the same time as a cosmetic procedure.

My question is does this definitely disqualify me for any coverage along with plastic surgery even if I have cir****tances of rashes and back pain?  Do I have a chance in hell of getting help from my medical coverage with my future plastics?  I have a lot of time to go before I pursue plastics but I was concerned with the process of seeing my doc for skin rashes and documenting before I am ready to have plastic surgery.  I would hate to go through the aggravation without even being eligible for it.  I know I need to call in the future to find out for sure but just thought that somebody might have experience with this here.  My insurance is Blue Cross and Blue Shield of Rhode Island, City of Providence.

Thank you in advance for your help!
Donna Jean

 I had BC&BS of Massachusetts and my PS was covered. They covered the panni removal but I opted for extended TT so I had a out of pocket payment.. but worth every penny ~  Good Luck.. 

 You look awesome!!!! Thanks.

I have BCBS of illinois and i have obtained an approval for a pannectomy and lipectomy. The key word is what is considered cosmetic. Generally if you can prove you have rashes and other issues you can get the pannus covered. I have not had any luck with any thing else. The issue you might have is finding a dr. who is willing to work with the insurance. I had a list of 9 pages of PS in my network. and not one on the list would work with my insurance. Everyone of them wanted me to pay up front and once insurance paid they would refund me that amount.  Now I did run into a few out of network providers that i am working with now. But this automatically makes the oput of pocket for me to go up dramatically.

 Thank you so much for the information.  This helps me to not feel so hopeless.  I am getting plastic surgery not matter what but I thought at least I could use some help with it.  I think I will talk to my PCP about it.

Hi Donna Jean.  There are thousands of different versions of the BCBS plans, so you did good by checking your own plans language.  However, just because they exclude cosmetic surgery and do not take into account emotional distress from the excess skin does not mean they don't cover plastics altogether.

Check for language that allows removal of excess skin in cases where recurrent infections occur.  While you won't likely get it all covered, it may help you save some money.

My website www.drlomonaco.com has a link to one the BCBS plans that closely resembles many of their other products under the Patient Resources section.

Best

Dr. L.

Dr. L,

Thank you so much for the information.  I am now encouraged to pursue this further with my health insurance company.  I have read many of your responses.  We are lucky to have your input here.

Thanks for caring,
Donna Jean