Insurance and plastic surgery

cindy5089
on 12/30/10 6:19 am - Cedar Park, TX
 This might sound dumb, but does insurance pay for things like tummy tucks and the surgery for your "bat wings" or do you have to pay out of pocket?  I would love to have both done, but unfortunately, I am not made out of money!  Thanks!
paranoidmother21
on 12/30/10 9:01 am - Lake Zurich, IL
There is no good answer - it depends entirely on your insurance policy as defined and purchased by your employer.

Mine paid for the batwings, LBL, BR/BR, and will pay for thighs sometime before 10-2011. But that's a rarity, and I had enough medical issues from the skin that I know why they covered everything except the thighs (but I ain't arguin' about it AT ALL!).

Check your policy for details.
Rebecca
Circumferential LBL, anchor TT, BL/BR, brachioplasty 12-16-10 Drs. Howard and Gutowski

Thigh lift 3-24-11, Drs. Howard and Gutowski again!
Height 5' 5".  Start point 254.  DH's goal: 154.  My guess: 144.  Insurance goal: 134.  Currently bouncing around 130-135.
      
birthdaygirl
on 12/30/10 10:05 am - Lithonia, GA
WOW!   if not too personal may I ask what magical insurance you had to pay for most of your surgeries....I know it has to be medically necessary but still what insurance company did you have.....it rocks!
              
HW/293....SW/276....PSW/168....CW/148...GW/150  
paranoidmother21
on 12/30/10 10:32 am, edited 12/31/10 4:19 am - Lake Zurich, IL
 Blue cross- Blue Shield of Illinois as their HMO Illinois program.   My physicians tell me that the HMO is actually easier to deal with htan the PPO.  Dunno why, just very, very glad.

::edited to remove the stupid spelling errors - that's the LAST time I respond to a post from the Blackberry!  I can't see the screen worth anything!::
Rebecca
Circumferential LBL, anchor TT, BL/BR, brachioplasty 12-16-10 Drs. Howard and Gutowski

Thigh lift 3-24-11, Drs. Howard and Gutowski again!
Height 5' 5".  Start point 254.  DH's goal: 154.  My guess: 144.  Insurance goal: 134.  Currently bouncing around 130-135.
      
birthdaygirl
on 12/30/10 11:18 am - Lithonia, GA
Thanks for info.....I too am from Illinois....Chicago suburbs....Orland Park...I have been in Atlanta for about 4 years...because of my disabilites in the past and weight Blue Cross would not cover me years ago..lol....now I bet they would have at my current weight...go figure.....but here in Atlanta I have Meidcaid...a HMO (Peachstate Plan) and they rock....they pay for all my meds, my lap RNY on the first try.....thank God..and they will be covering my panniculectomy because it is medically necessary and possibly my breast lift......thighs I don't know but there are rashes and discomfort there too but they may be a long shot...but abdomen and breast I will be thankful for cause extra skin in those areas cause a lot of rashing and pain for me....
              
HW/293....SW/276....PSW/168....CW/148...GW/150  
paranoidmother21
on 12/31/10 4:24 am - Lake Zurich, IL
Orland Park is a lovely town - I have cousins and aunts/uncles down there (family was originally South Side German/Irish, then dad got transferred to O'Hare and we moved waaayy up north).

I'm glad your insurance works well for you.  Some questions my surgeon's asked about were quality of life issues: skin sticking so that I cannot sit or move comfortably, intimacy issues, mental health issues.  In my case, the skin sticking is likely what got me the back side of the LBL, but the BR/BL/Brachio was due to a pulled/torn chest wall muscle. 

Document everything - that DID make a big difference in the letters of support from my PCP and the breast specialist at my ob/gyny when we filed for insurance.
Rebecca
Circumferential LBL, anchor TT, BL/BR, brachioplasty 12-16-10 Drs. Howard and Gutowski

Thigh lift 3-24-11, Drs. Howard and Gutowski again!
Height 5' 5".  Start point 254.  DH's goal: 154.  My guess: 144.  Insurance goal: 134.  Currently bouncing around 130-135.
      
birthdaygirl
on 12/31/10 6:27 am - Lithonia, GA
thanks Rebecca....I will be documenting everything...I mean everything!.....need to get as much covered as possible to look back normal....I rather have scars than excess skin anyday....I ain't trying to pose for playboy!.........WELL UNLESS THEY ASK ME!
              
HW/293....SW/276....PSW/168....CW/148...GW/150  
(deactivated member)
on 1/3/11 12:33 am
paranoidmother21
on 1/3/11 1:30 am - Lake Zurich, IL
Ohhh, believe me I get the detail!  Been there, lived through that!

The main thing that got me the BR/BL/brachio was a pulled/torn chest wall muscle from dragging skin that would not heal until I had the PS.  A detailed letter from the breast specialist at my ob/gyny along with pics from the PS was all that took.

The circumferential LBL was a combination of nasty infections like yours documented both by time-stamped pics and calls to my PCP as well as a few visits, and then complaints about my butt sticking to my thighs, making sitting difficult.  The PS was surprised that they agreed to the full LBL: they thought it was likely I'd only get the panni approved.  Guess he took great pics of things sagging and bagging!

All in all, I spent about 3 months from the first visits for the chest wall muscle and infections until I had my first PS consult, submitted for insurance approval at the first consult, was approved 5 weeks later, and (due to my schedule) chose to schedule surgery 8 weeks later.

The anchor cut was not covered by insurance per se, but the PS told me that it would add 5-10 minutes to the surgery that was covered, and that they could fit it in during the time covered so there would be no extra charge.  So far, no bill.

If you want any other info, PM me and I'll get back to you.
Rebecca
Circumferential LBL, anchor TT, BL/BR, brachioplasty 12-16-10 Drs. Howard and Gutowski

Thigh lift 3-24-11, Drs. Howard and Gutowski again!
Height 5' 5".  Start point 254.  DH's goal: 154.  My guess: 144.  Insurance goal: 134.  Currently bouncing around 130-135.
      
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