approved!!!!

 my dr sent for prior authorization for my panniculectomy on friday afternoon and i just got the call saying i am approved!!!! surgery is scheduled for july 5th.

Congrats! I bet you are through the roof excited!!

How does one get approved? I mean what is the criteria for insurance companies to approve these kinds of procedures? I am curious for when my time comes TIA!!

There is a LOT of variation.  The best thing you can do is to contact your insurance company now and find out what they will cover and what conditions you must meet in order to get it covered.  Then start on this NOW!  Start getting things documented in your medical file now to be used when you want plastics and are going to send off for authorization.

My insurance (Aetna via UPS) will cover abdominoplasty if the pannis hangs below the pubis AND you have 3 months or more of medical documentation of rashes that are not helped with medical treatment.  I found this out and ran to my PCP with any tiny little skin issue to get it documented.  I've sent off for approval, but I'm not sure if I'll get it as my pannis isn't quite below the pubis (depending on where they determine the pubis is).......

Some insurance companies will cover paniculectomy only.  Some will cover breast lifts or arms.  Some cover nothing at all.

Some require you only lose 100 pounds or more.  Some require medical documentation of medical issues (like mine).

Congratulations!  I am dancing with you, I just got approved as well and my surgery is scheduled for June 24th.  Take care!!!!!!!!!!!!

Lia d

Congrats!  That was fast!

My doc sent off for approval for me on Wednesday (11th).  They didnt' send pics, so they were supposed to send those today.  I'm following up direcly with my insurance company to make sure they get everything they need.  Fingers crossed that I get approval!

My surgery is scheduled for 5/26 and I'm getting it whether I'm approved or not, but it sure would be nice to have insurance help to pay for it.