APPROVED!
I found out today that a portion of my PS has been approved! I jumped through all the hoops in hopes of getting approved, but had convinced myself the entire time that it wouldn't really happen.
I'm getting an LBL with brazillian butt lift and a smidge of lipo on the outer thighs on THURSDAY (5/26)! I've already paid the self-pay/cosmetic price of $12,760 so this means I'll get a bit of a refund.
The PS office called and said my paniculectomy portion was approved, but my insurance (Aetna) actually covers abdominoplasty, so I guess I need to clarify. If an actual abdominoplasty was approved, doesn't that cover the muscle tightening as well as the skin removal? If so, then my refunded portion should be even larger.
The hospital bills differently for cosmetic vs medical procedures (to help self-pay patients), so all the numbers have to be rerun and reconfigured. I'm just grateful to be getting some money back, even if it's only $1500 or so.
I'm getting an LBL with brazillian butt lift and a smidge of lipo on the outer thighs on THURSDAY (5/26)! I've already paid the self-pay/cosmetic price of $12,760 so this means I'll get a bit of a refund.
The PS office called and said my paniculectomy portion was approved, but my insurance (Aetna) actually covers abdominoplasty, so I guess I need to clarify. If an actual abdominoplasty was approved, doesn't that cover the muscle tightening as well as the skin removal? If so, then my refunded portion should be even larger.
The hospital bills differently for cosmetic vs medical procedures (to help self-pay patients), so all the numbers have to be rerun and reconfigured. I'm just grateful to be getting some money back, even if it's only $1500 or so.
Congrats!!!! Good luck with your surgery!
Laina B.
250 / 160
9/9/03 Lap RNY
(Dr Charles Beall, Tyler TX - AWESOME!!!)
5/13/11 Cholecystectomy, extended abdominoplasty (anchor cut), and mastopexy
(Dr Charles Beall and Dr James Saar, Tyler TX - AWESOME!!!)
8/26/11 Abdominoplasty revision
(Dr James Saar, Tyler TX - AWESOME!!!)
I have Aetna through UPS - the managerial level plan. (I think the hourly/union workers have a different plan.)
They require at least 3 months of documented skin issues that are not improved via medical treatment AND the pannis must hang below the pubis. (Mine hangs over the pubic hairliine a bit, but does not cover the entire pubic region.)
I went to my PCP with every little skin issue.....even if it was an ingrown pubic hair. He documented it all for me in my medical records and then I wrote the letter for him recommending reconstructive surgery for medical reasons so that I would ensure that it had everything listed just as my insurance required. He put it on his letter head and signed it and then I took that, with the medical records documenting the dates of the skin issues, to the plastic surgeon who took pics and sent it all off.
If you want, I can email you a copy of the letter I used.
They require at least 3 months of documented skin issues that are not improved via medical treatment AND the pannis must hang below the pubis. (Mine hangs over the pubic hairliine a bit, but does not cover the entire pubic region.)
I went to my PCP with every little skin issue.....even if it was an ingrown pubic hair. He documented it all for me in my medical records and then I wrote the letter for him recommending reconstructive surgery for medical reasons so that I would ensure that it had everything listed just as my insurance required. He put it on his letter head and signed it and then I took that, with the medical records documenting the dates of the skin issues, to the plastic surgeon who took pics and sent it all off.
If you want, I can email you a copy of the letter I used.
That is exactly what my dad told me we have.
Come to think of it, I have been to the doctor sooo many times for pubis skin issues that have been unable to be solved by many antibiotics. I think they said it was folliculitis just infected hair follicles which has caused me pain. I never thought of it being connected to my skin issue but that makes a lot of sense!
I'd love a copy of the letter as I have not a clue how I should present the information in order to better my chances.
Come to think of it, I have been to the doctor sooo many times for pubis skin issues that have been unable to be solved by many antibiotics. I think they said it was folliculitis just infected hair follicles which has caused me pain. I never thought of it being connected to my skin issue but that makes a lot of sense!
I'd love a copy of the letter as I have not a clue how I should present the information in order to better my chances.
I'm jealous!!! Mine was not covered in any way, shape or form - so I am HAPPY for you!!! Any portion that's covered is great!! And yes I think an abcominoplasty usually does include muscle tightening - mine did.
Highest/Surgery/Current/Goal
250/241/139.5/125
I have a new philosophy, I'm only going to dread one day at a time. Charlie Brown