Questions about getting PS approval

I'm thrilled with the success I've had with my surgery, but really disappointed by all the excess skin.

My inner thighs, breasts, and tummy, are a mess!  My arms are okay, but the wrinkled look, and muffin top of skin, over my bra is really bothering me too. 

I'm having skin crease issues under my panni (pain, burning, & redness), which I'll be treated for again on the 23rd.  My inner thighs are so wrinkled, plus I have a problem with black heads that just won't go away.  My breasts are like empty skin flaps (cones)... ugh!  I'm now having burning irritation in my arm pits.

So, with all that I have explained above...  Do you think I will have a chance of getting approved, based on my skin issues, once this is all documented with my doctor? 
My insurance company already said that skin removal is a covered benefit....   but I want to make sure all my ducks are in a row.

Thank you for taking the time to read my post.  I'm looking forward to your feedback  :)

Roxzy

Call your insurance and ask them what you need to do to get their approval. Mine required I visit my PCP 3 months in a row so PCP could document my intertrigo rash (I asked that she make that the primary  reason for the office visit) and I had to buy prescription medications each time. As well my panni had to cover the pubis bone as documented by photos sent in by my plastic surgeon. I didn't need photos of the ra****self (which is good because I didn't have one under the panni, my problem was my belly button LOL) This is a fairly common request, but each company has their own set of instructions.
 
Follow the exact instructions that they give you and hopefully the process to approval will be easy.

Unforunately, you are unlikely to get anything but a panniculectomy  (but not a full tummy tuck) paid for by insurance.  I had very similar rash issues in my armpits that I had below my belly (and would cut myself shaving (whihc is a problem when you take blood thinner), but despite pictures and letters of medical necessity from both the PS and my PCP, the insurance company refused to even consider paying anything to have the extra skin removed from my armpits.

Lora

Yes, I'm aware that they will do removal of the skin on the abdomen, but will not do the muscle tightening (that will be out of pocket).   I'm also hopeful that they will do the inner thighs, the rest I can live with.    :)

FWIW, even on the PS board I have never heard of anyone getting a thigh lift paid for by insurance.

Lora

Thanks Lora :)  It's probably just a pipe dream on the thighs, but going to try anyways... having skin issues :(  acne type.

Roxzy

:::waves hand in the air annoyingly::: 

I am. 

I don't know why, nor does my surgeon, however we're not going to look the gift horse in the mouth!  They're covering skin excision from my thighs.  And since my thighs NEED IT, we're very glad!  It's scheduled for next week, 3-24-11.

Thank you for responding Rebecca :)  I'm glad to hear there is hope!  Going to get my ducks in a row... and go for it!  I have called my insurance twice, they said if its medically necessary, then it can be approved with the appropriate documentation.  Not going to hold my breath, but remaining hopeful :)

Roxzy

You're welcome!

I did a lot of whining and documentation pre-initial consult.

I made sure that all rashes, sticking, extra showers, pain, EVERYTHING was logged daily in a little notebook, and had regular conversations with my PCP and my gyny's office.  I also got my body fat down to about 20%, which meant that all that was left was skin, and then demonstrated what I could do with that skin because there was so much of it.

I had immediate letters of recommendation from various doctors! LOL!

Best of luck getting it covered.

I am scheduled for my brachioplasty and medial thigh lift on 4/11/11.  Both covered by insurance.  I did have to write an appeal letter, but was approved within a week of sending that letter.  I have already had a complete tummy tuck and breast lift covered by insurance.