need advice on plastic surgery HELP

Schloe78
on 6/8/11 8:09 am

OK so Iam 2 years post op and at goal with no regain.  HAPPY!!!  I need to fix my skin mostly because it keeps me from doing the things I have learned to love like excercise. I run three miles 2 x a week and my arm skin is chaffed and sore. My inner thighs are sore and rubbed raw. My back is killing me with all the skin on my tummy.  So I need to look in to having this fixed but, money is a huge issue. I have BCBS and was wondering if any one out there has had any luck with getting this insurance to help with plastics?? How much for a LBL?? any good surgens in the state of maine???

Amy Farrah Fowler
on 6/8/11 8:33 am
 I was not successful with having any plastics covered by my insurance, despite having the rashes and skin break down under the panni, but think it's worth a shot, especially since some really should be covered after massive weight loss.

That said, the rule to follow if you are trying to get plastics covered, is document, document, document. Make an appointment to see your doctor for the skin problems. Make this it's own appointment, don't just mention this in passing when you have an appointment for something else. 

Follow any advice the doc gives you to try to resolve the issues  - apply any ointment, dry under folds with the hair dryer, etc. Keep photos of the problem. Keep all info from any visits related to the skin issues. Any and all of this may be useful in getting things covered.

Like I said, my insurance said "no", so I opted to self pay. Despite spending a small fortune, I feel like it's some of the best investing I've done, and have no regrets. 

(deactivated member)
on 6/8/11 9:28 am - Yorktown, VA
You need to contact your insurance company and find out exactly what reconstructive surgery they will cover and what criteria must be met in order for them to cover it.  Then you need to start getting that criteria met.  It's often via medical documentation of problems, like the poster above mentioned.

I got Aetna to pay for the panni removal portion of my LBL.  The total cost was about $13k and they paid $3k of it.

Good luck!
paranoidmother21
on 6/8/11 9:30 am - Lake Zurich, IL
It's not so much a matter of what insurance company your policy is through as it is who pays for the policy - and what they're willing to pay for. My daughter and I both have BCBS-IL through different employers, and my policy covered EVERYTHING that was deemed "medically necessary," while my daughter's policy specifically excludes any surgery for weight loss even if medically necessary, and any plastic surgery not related to cancer or serious accident reconstruction.

So your first step should be to contact your insurance company and find out what your policy states. The advice my surgeons gave me was to NOT ask about plastic surgery, but rather to ask about medically necessary reconstructive surgery. If it's not specifically excluded, start hitting up your primary care physician with EVERY complaint you have about your skin.

Best of luck with it!
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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