so disapointed

Well I'm so frustrated and disappointed right now. Lost another appeal for some plastics for breast reduction and lift. Just don't understand!!!! Why do they think this is just for cosmetic reasons. They don't have a clue what I have to deal with. Just wish they would have to walk in my shoes for a day. Bad day!!!!!!!!!

I'm a single mom and don't have extra money for this and my insurance does cover it. I have two surgeons state that I have one of the worst case they have seen so why doesn't my insurance see that. All I want to do is cry!!!

Julie

 I'm so sorry Julie!

What is your insurance company's "criteria" for a breast reduction? I would assume you have already lost too much tissue to consider it a reduction so it would truly only be a lift (that's how mine was explained to me)

Try appealing using aspect of back pain and orthopedist AND letter of removal of excess skin from hanging pendulous breasts.
I hope you can win. We each deserve the best body possible after what we had and worked and struggled to change.
Mikimi in Israel

The insurance companies are very difficult to deal with, but most have published guidelines that they require to qualify for surgery.  In most cases, they are going to require removal of 500G of tissue from each side (that's a litte over 2 lbs).

In my experience, most weight loss patients have lost most of their breast tissue and are left mainly with excess skin.

Here are some links to the insurance plans and some tips on getting approval from my website:

http://www.drlomonaco.com/tips-on-getting-insurance-for-plas tic-surgery.shtml

Thanks all for responding.

I have 2 different surgeons say my breasts are 600 plus. We also have over a hundred pics of rashes, sores on top of my shoulders etc etc. There is no excuse to denied this. My surgeon will continue to fight this my doing something called a review hearing and even writing a grievance to someone.

I'm very sadden about this but felt better that I have Dr's that will continue to fight for me

Julie

That's frustrating !

If you have been given medications for the rashes (which is what many of the companies require) then your insurance company has already paid for those prescriptions.

That should be in their records, but sending them copies of your scripts to prove that you have treated them medically with no success may help.