Approved by BC/BS Federal

I am so beyond thrilled right now!  I received the approval letter from my insurance company for the removal of my excess skin (panniculectomy).  The approval took about a week!  I am in shock!

The PS that will be doing my surgery does do the muscle repair also so I will get a full tummy tuck.  My surgery has been scheduled for December 19.  I hate that I'll feel crappy for Christmas, but I scheduled it that way so my kids would be home on Christmas break so they could help me and work tends to be less hectic during the holidays.

I just had to share my good news.  I waited SO long to submit because I just didn't think I looked 'bad enough' to be approved.  I guess the moral of the story is - you never know till you try!!

YAY!!

Congrats!

Congrats!!!

Congrats.

Did you have to jump through a ton of hoops ?  What was your process ?  

Thanks for any insight.  

Believe it or not, there were no hoops.  I called to see what the requirements were for approval and they just said it has to be "medically necessary".....so that left it wide open.  However, most insurance companys go on the basic information 1) lost more than 100 pounds 2) weight has been stable at least 6 months 3) pannis hangs at or below the pubis 4) skin causes infections.

I met all the requirements BUT barely (other than the weight loss and sustained weight).  I didn't hang very far and I had no documented infections.

I went for the PS consult and she wrote a letter of medical necessity.  She also took pictures.  My primary care physician wrote a letter stating that I had a stable weight for a long time and that I had "complaints" of moisture and redness and that he was conerned I would have infections, but I didn't have anything documented.

We submitted it and I was approved within days.  I will say that Blue Cross/Blue Shield Federal is a good insurance.  I didn't have any issues with my gastric bypass being approved either.

I am so thankful because I know some people really struggle with their insurance - but I am very blessed.

 

I have a question.... I am searching for medical insurance to purchase then go through the steps for an approval with the insurance company. The main one I have found is BCBS Smart Sense Plus POS 3500 plan. Could you tell me which plan you were under? and if it was a plan approval with BCBS or an employer stipulation approval?

Thanks
Casey

 Congratulations!  What a great Christmas gift for you!

Hi Casey,
I have Blue Cross/Blue Shield Federal.  My husband works at the Post Office.  I'm not sure what you mean as for as the plan approval....but it wasn't an exclusion and the requirements were only "Medical Necessity".  You can IM me if you have any more questions, I'll be happy to try and help if I can.
Good luck!!
Jen

Congrats on the approval! This gives me hope now :) 
Would you mind sharing which surgeon you are using? I'm just starting to research plastics. I'm in Ohio and I know a lot won't work with insurance companies.
Thanks so much. Best of luck!

Ashley,
I am going to Dr. Jennifer Butterfield.  She's great.  I would highly recommend her and her staff.  She is straight forward, no "fluff" and she does great work....PLUS, when it comes to panniculectomies she ALWAYS does muscle work too - that is her philosophy.  So along with the fact that she has done a lot of PS on previously overweight people, she works with insurance companies AND she will do the full tummy tuck - it was a NO brainer!  I would highly recommend seeing her and discussing your situation.  She wrote a great letter explaining why I needed the surgery (I asked for a copy of it).  Please IM me if you want to talk more about her or anything else to do with this process!
Have a great weekend,
Jen