Insurances that cover PS?

Mary B.
on 1/31/12 11:20 pm - Southern, MD
Im curious if you have had insurance cover your ps? I currently have fed bc/bs. I understand they often cover ps due to weight loss and they cover it as 'reconstructive' surgery.

Anyone have experience with this insurance?

Also, Im seriously considering/looking for a new job. I'd like to now if insurance covered your ps, who do you have? Just something to keep in mind while Im on the job search.
    Banded Feb 23, 2009 / Revision to RNY Aug 25, 2010
 
PBJ
on 1/31/12 11:27 pm
good luck.  I was totally self pay but I know alot of others here had insurance pay for part or all of their surgeries.  So hopefully you can find some help here!

Patty
My weight loss journey                                                    
Danae T.
on 2/1/12 2:19 am
I have insurance through a local electical coop. It is administered through CBA. They covered my BR/BL no problem, but denied the pannie due to cosmetic. I am fighting them on that.
    
Danae T    
Kristie S.
on 2/1/12 5:23 am
I have BCBS and they covered my TT as medically necessary.
Kristie
  
BonBon1
on 2/1/12 6:47 am - Somewhere, GA
I have Fed. BCBS and they covered my TT.  They will not pay anything on the arm lift I desperately want, and need though. 
  Good luck with your job search!
happytrails12
on 2/2/12 1:47 am - Aldie, VA
I haved Fed BCBS too.  How did you get them cover your TT?  It would be a true blessing if they cover my TT.
BonBon1
on 2/2/12 7:01 am - Somewhere, GA
Happytrails,  they  denied my request at first because the dr. didn't send the proper info.  So DH took very explicit photos, and wrote a massive appeal letter with documentation from several doctors.  They approved the TT very quickly after that! 
Britt U.
on 2/2/12 2:42 pm - Mill Creek, WA
I have Fed BCBS and I didn't even try. I figured since I didn't have as much hanging skin or skin issues on my tummy it'd be a tough fight. And they were sooooooo horible when my lap band slipped and damaged my stomach. I fought for a 7 months to have it taken out and finally won. But then fought for another 7 months for revision and lost, it was ridiculous with twists and turns that should be in a Lifetime Channel movie (like the local BCBS administrator writing in letters that it was my fault the lap band broke, or a letter saying I didn't meet the standard of obesity so they couldn't remove it - duh, it worked before it broke so my BMI was lower). I went all the way to the top of the OPM in DC. It took so much out of me that I just didn't have the energy to do battle again.

However... my surgeon and dermatologist are writting letters and doing a pre-auth on inner thighs as I do have a medical condition there and the excess skin isn't helping. We'll see what happens. Even if approved it still wouldn't cover the full thigh lift but it might help.

There's so much judgement and discrimination out there against people who are obese, have weightloss surgery, or plastic surgery that I think being really buttoned up and clinical in the way you go about the pre-auth is important. I haven't allowed any mention of my second weight loss surgery to be on my medical records anywhere, it was self-pay and it can only hurt me and be used as a way to deny me coverage for reconstructive surgery or if something were to go wrong with my stomach. 

It was amazing how obvious the discrimination was in the comments and letters that went back and forth on my case. If anyone had added the kind of personal judgements in legal or business documents that were written about me on my case on a case where the patient had a physical handicap or was of a minority race or orientation they would have been fired. If I could have figured out where to find a lawyer to work with in D.C. I would have sued the OPM directly, that's the last legal option after an appeal fails.

I ranted there, sorry :-). Basically I'm just saying go for it with BCBS but be cautious about what goes into the pre-auth or related letters when it comes to past obesity or to weightloss surgery. There's a lot more support for people losing weight through diet and exercise (when it doesn't work as well, go figure) so sticking to the explanation as simply "after significant weightloss" can get through the system better than if there's reference to surgery. 
                
Mary B.
on 2/3/12 4:39 am - Southern, MD

OMG! Im sorry you had such a hard time. That is absolutely ridiculous what they put you thru! Must have been the particular office you were working with?

I was self pay with my band. I then got BCBS Fed. The covered my revision to rny no questions, no problems. My 'technical dysfunction' with the band was insufficient weight loss and a slight slip.


wow.

    Banded Feb 23, 2009 / Revision to RNY Aug 25, 2010
 
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