Will Aetna approve a TT or a Panni???

So long story short- had RNY in 2007- lost 127 lbs- gained 60 back-had revision surgery Feb 2011- lost another 80 pounds
I have the skin hanging over the pubis and my revision doc who does the TT and Panni as well said I needed both and that insurance should cover it
I ttok pics and had the documentation from the 9 months of rashes, odor and pain from the skin sent over....
Will Aetna approve this? If so, how long could it take?

 I have Anthem BC of CT, but they approved me in 3 days.  So, it doesn't necessarily have to take along time.

I hope to be approved quickly...I cannot wait to get this done!
Please let me know what your doc sent over...if you would be so kind...

He took what I jokingly call "med porn" pictures and told them that my hernia repair and healing would be compromised if the panni wasn't removed at the same time.  Because one of my hernias was above my navel and all my ab muscles were separated I had a full tummy tuck done.  I also wrote a letter detailing the impact the panni had on my daily living. I don't know what ultimately swayed the insurance comany- the God-aweful pictures, my doctor's medical position, my letter or a combination. 

Do insurance companies actually cover a TT?

I've heard cases of people getting the panni covered under medical necessity and then paying the difference for the TT out of pocket - haven't yet heard of an insurance company willing to pay for a TT! 

Very curious about this.

I have BCBS and they paid for an Extended Tummy Tuck/muscle repair. 

I had my PS take pics and I had a letter from my family doctor stating I have been treated for skin rashes/yeast infections.  Got approved right away!

Yes...I have Aetna.  I had a consult with a surgeon, and he said his practice routinely works with Aetna and fully understands their requirements, routinely gaining approval for patients.  He said they will approve for the front, I guess pani or TT, but will not pay for work done the the backside.

Thanks for that info!!!

May I ask who your surgeon is and how long you took to get approved?



This is not me but is the EXACT copy of what my belly looks like now...

I did not choose him.  I actually went to him for a facial consultation, and he wanted to go ahead and give me a quote for the LBL because he asked if I was going that route also.  I have not had any surgery.  His name is Dr. Lyos in Houston...I think that is how it is spelled.  He said approval is easily gotten with the proper documentation.  You should have not difficulty getting Aetna to approve.

My husband had his panni yesterday.  We had to appeal to Aetna to get it approved, and that was WITH documents about yeast infections, etc.  They said it did not hang low enough.  Well, we appealed and they did approve, but not a TT, and not the reconstruction of his navel.  Well, he wanted a belly button damn it, so we paid for that part of the surgery out of pocket. 

Here in NH, a new BB costs $975.

Our insurance DID change as of 1/1, from Anthem BC to Aetna, so I think they denied it just because it was submitted so close to the change in coverage.  Anthem BC had already approved the surgery, before we found out about the change in insurance, we used that as part of our appeal process.

My point?  You just don't know who will be approved and who might not be, the cir****tances of each case have to be considered.