Which insurance companies in So.Ca. are covering T.T.'s.
I know it is very hard to get coverage for plastics.
I do need a t.t..
My medical problem is a herniated disc and my huge panni contributes to this.
I currently have an H.M.O and also am wondering if it is easier to get covered for this with a P.P.O.?
I have 9 more days for "open enrollment" to change to a P.P.O.
Please let me know your thoughts.
I do need a t.t..
My medical problem is a herniated disc and my huge panni contributes to this.
I currently have an H.M.O and also am wondering if it is easier to get covered for this with a P.P.O.?
I have 9 more days for "open enrollment" to change to a P.P.O.
Please let me know your thoughts.
"And we know that in all things God works for the good of those who love him, who have been called according to his purpose".
Romans 8:28
Aloha-
Most insurance companies have guidelines that must be met before they will cover plastics. You can check their websites.
I have Aetna ( PPO) and they would not cover my VSG, but did cover the panniculectomy portion of my circumferential lower body lift. Their website clearly states when they cover it- pannus hanging below pubis, recurrent infections poorly responsive to medical management over a 3 month period, repair of a true incisional or ventral hernia -etc.
http://www.aetna.com/cpb/medical/data/200_299/0211.html
I would add that I first sought pre-approval through a plastic surgeon who was in network, she submitted the photos and measurements. Because that surgeon does not perform CBLs, I had to resubmit under the out of network provider that I chose- and it was only a slight hassle ( they couldn't very well say it was not medically necessary after already approving it through an in network provider). So if you switch to a PPO, bear that in mind.
I've also heard that if you have lost over 150 lbs, as I had, they are more likely to cover it even if you do not meet their other criteria. Be certain to have the provider document all your problems ( the pain from the disc, any infections) and submit photographs if your pannus hangs below your pubis.
Best of luck- XoLori
Most insurance companies have guidelines that must be met before they will cover plastics. You can check their websites.
I have Aetna ( PPO) and they would not cover my VSG, but did cover the panniculectomy portion of my circumferential lower body lift. Their website clearly states when they cover it- pannus hanging below pubis, recurrent infections poorly responsive to medical management over a 3 month period, repair of a true incisional or ventral hernia -etc.
http://www.aetna.com/cpb/medical/data/200_299/0211.html
I would add that I first sought pre-approval through a plastic surgeon who was in network, she submitted the photos and measurements. Because that surgeon does not perform CBLs, I had to resubmit under the out of network provider that I chose- and it was only a slight hassle ( they couldn't very well say it was not medically necessary after already approving it through an in network provider). So if you switch to a PPO, bear that in mind.
I've also heard that if you have lost over 150 lbs, as I had, they are more likely to cover it even if you do not meet their other criteria. Be certain to have the provider document all your problems ( the pain from the disc, any infections) and submit photographs if your pannus hangs below your pubis.
Best of luck- XoLori
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