Starting my plastics journey...
And I thought getting things in order for my RNY was complicated! There are so many things to think about when it comes to this process and I am feeling a bit overwhelmed and could use some guidance from a veteran or two...
I had my first plastics consult in August--a little over 10 months out when I hit my goal weight (145 lbs down from 286 lbs 5'2 day of surgery). At that time the surgeon had told me that I would need a two stage proceedure, starting with tummy and thighs and then arms and breasts. He also told me that though my abdomonal skin was hanging low and at that point causing me issues with infection etc I was not going to be covered for insurance. I had been plataued at my weight loss for three months and I thought that at that size (a size 8) I was right about were I was staying.
Fast forward to now, 7 months later, and I am down to 115 lbs and a size 0/2, which is where I have been since November with little to no fluctioation. The amount of pain and discomfort I have from my sagging skin (esp. in the abdomen and breast area) has increased as well as the effort I have to put into infection control. I am wondering if this change might have affected if insurance will cover the cost of my plastics? I am also concerned, even if it sounds silly, over how small I am going to be post surgery if I am already in XS/ size 0 clothing now with the skin. Has anyone else had this issue?
I had my first plastics consult in August--a little over 10 months out when I hit my goal weight (145 lbs down from 286 lbs 5'2 day of surgery). At that time the surgeon had told me that I would need a two stage proceedure, starting with tummy and thighs and then arms and breasts. He also told me that though my abdomonal skin was hanging low and at that point causing me issues with infection etc I was not going to be covered for insurance. I had been plataued at my weight loss for three months and I thought that at that size (a size 8) I was right about were I was staying.
Fast forward to now, 7 months later, and I am down to 115 lbs and a size 0/2, which is where I have been since November with little to no fluctioation. The amount of pain and discomfort I have from my sagging skin (esp. in the abdomen and breast area) has increased as well as the effort I have to put into infection control. I am wondering if this change might have affected if insurance will cover the cost of my plastics? I am also concerned, even if it sounds silly, over how small I am going to be post surgery if I am already in XS/ size 0 clothing now with the skin. Has anyone else had this issue?
I was a self pay for plastics but I have seen several members here get full or partial insurance coverage for the abdominal part of their surgery. The key here seems to be fully documenting the rashes and infections and any other adverse effects that this excess skin has been causing you. Can or has your regular doctor been documenting this? Can he/she provide details of the visits you have made to him/her for treatment? Can you get records of any prescriptions provided to treat the conditions? Got any photos? From what I have read on the board, you and your main health care provider can pursure this coverage with your insurance company.
It looks like alot of hoops to jump thru but any savings offered by partial or full coverage can be a blessing. I am sure that one of the members who has been thru this can jump in with more advice but you can also spend some hours going over the old posts. I know I have seen this discussed fairly regularly on the boards.
Good luck!
It looks like alot of hoops to jump thru but any savings offered by partial or full coverage can be a blessing. I am sure that one of the members who has been thru this can jump in with more advice but you can also spend some hours going over the old posts. I know I have seen this discussed fairly regularly on the boards.
Good luck!
I had 3 consults. One surgeon said he felt strongly, my insurance would pay for TT....front but nothing in the back. That really surprised me because my greatest issue is my butt and thighs. He said he has great success filing claims with my insurance company. With your issues, you just might be able to have insurance pay. Perhaps you should have more consults to find out what other PS's say.
That doesn't make sence... if you're having infections then insurance would deem it medically necassary to get rid of the skin. You should call you insurance yourself and ask because your surgeon doesn't seem to know what he's talking about...
5" 7' - HW: 328 Current: I stay around 155 :)
"...Because when you stop and look around, this life is pretty amazing."