Insurance covering panni

I've heard a lot of disagreement from people on whether insurance covers an panni or not - some people say it was easy, others have told me it's impossible.  Is it that each insurance is so different, or each person's skin is so different?

On one hand, I'm told I'm a poor appliant to have insurance cover my panni because it's "not that bad" and there's no infection or abrasion.  But I'm also told that "it's a done deal" because I live in California which has different insurance laws.  

How can I become 'less stupid' on this and learn more?

I think the only way to find out is to contact your insurance company.  Every company (regardless of the state) is different.  If your employer doesn't have it as a covered procedure in your insurance plan, the state doesn't matter, unless you have state insurance. 

I'm going through the appeals process now but I don't have enough hanging down and haven't had any rashes so it's not looking too good.  I used to be grateful that my 170 lb loss didn't cause me to have as much skin as others, but now it's almost bittersweet.

Bottom line is that each situation is different and you really need to talk to your insurance company.

Best of luck to you!

Ah ha, thanks for that very helpful tip!  I'm assuming they do cover it since I have "pretty good insurance" but you're right, I should call them.  Thanks!

I have 'pretty good insurance' from a great fortune 500 company, but they did not pay for my band or for any plastics ------ so, check on your own policy.

Also, they may pay for a panni, and you might want a full tummy tuck, so, ask your surgeon if they can work out a deal where the insurance pays some, and you pay the difference.

Good luck

It depends on the insurance and the problems the panni has caused.  I documented for over a year with prescriptions, pictures, and letters from doctors for it to be covered by insurance.

Ask your insurance company.

What is abrasion.  I wonder if that is what I have on my right butt cheek?  Since losing weight I have an area on my butt that is not a rash but a deeply etched area.  I can feel it and it feels like dep lines running in my skin, very, very rough.  I  can't see it, so I do not know what it looks like.  Because the excess cheek skin folds onto each other from the left and right it is always rubbing, but it is on one side only.  I have used cortisone cream, etc. but have never been able to clear it up.  I'm not after insurance approval because I'm sure it would not cover but have been stumped on what this is and did not have it pre WLS.

Hi Ruggie,

I believe that the criteria for getting a panni covered by insurance is very subjective...it comes down to how it is classified by the surgeon that evaluates it.  There are people that look far better than I do and have had a TT (not a plain panniculectomy) fully covered.  Even Kaiser, who has some very straight forward criteria, still varies between surgeons and what is covered.  It all comes down to the surgeon that evaluates you and how well they think they can "paint" your condidtion to get it covered.  The surgeon that saw me is not in any way interested in helping me get anything done...he just wants paid for what he does...no matter where the money comes from.  I need to find a surgeon that can see the person and the effect their skills can do for me on every level.  It will be very hard for me because I have Kaiser insurance.  If you don't have Kaiser insurance, you will have an easier time and a better chance of finding someone that will be able to give you the results you desire and get it covered.  Best of luck to you and I hope you have a far better consult and outcome than I did with mine.  

 Hey Sharon,
  I was just thinking, does kaiser allow u to have another consult with a different Plastic surgeon?  Since the surgeon seems to have so much power to get things approved, maybe a different one in the system could help.  Just a thought.

Hugs
Patty

It is worth a shot to see Patty.  I will definitely be checking into it. 

My bariatric surgeon suggested a year ago that I document my symptoms, so I started taking pictures of the rashes on my belly. And when it came time to go to a plastic surgeon, not only did they have my original surgeon's documentation of chronic fungal infection, but all my dated photos as well. There was no problem in getting approval.