pre-emptive file building

Im looking to get a TT around August ( gotta build back FMLA hours since I stayed out a LONG time after VSG surgery) ....     so Im thinking Im a lil late on starting to build a file that will encourage Aetna to pay for it....

So far Im down 70 pounds ( not quite 5 months post-op) with another 70 to go....Im thinking about getting TT at about 160 pounds which is about 45 pounds away....that will make me about 115 lbs down.... 

So my major questions are, What "ailments" do I need to be suffering from to get insurance approval or partial approval?  rashes, etc...   Do I need to see dermatologist?? PCP...  will my own pics of these rashes suffice??   How much of a history of rashes and any other ailments do I need?

Is it possible to get insurance to pay for ventral hernia repair ( I was told I had hernia years ago) , panni and then I pay for the rest? 

http://www.aetna.com/cpb/medical/data/1_99/0031.html

The following procedures are considered medically necessary when criteria are met. The requesting physicians may be required to submit documentation, including photographs, letters documenting medical necessity, chart records, etc.

Panniculectomy: Considered medically necessary when criteria are met, as set forth in CPB 0211 - Abdominoplasty, Suction Lipectomy, and Ventral Hernia Repair.

Ventral hernia repair: Considered medically necessary when criteria are met, as set forth in CPB 0211 - Abdominoplasty, Suction Lipectomy, and Ventral Hernia Repair.

http://www.aetna.com/cpb/medical/data/200_299/0211.html

I think you answered your own questions. 

What "ailments" do I need to be suffering from to get insurance approval or partial approval?  rashes, etc...   Do I need to see dermatologist?? PCP...  will my own pics of these rashes suffice??   How much of a history of rashes and any other ailments do I need?

1. Your panni has to hang below the level of the pubis, and
2. The medical records (not your own) need to document that the panni causes chronic intertrigo (rashes/infections/chafing) that consistently recur over 3 months while receiving appropriate medical therapy (or stays despite the medical treatment).

As far as your hernia goes,

1. Aetna considers repair of a true incisional or ventral hernia medically necessary

• in order to distinguish a ventral hernia repair from a purely cosmetic abdominoplasty, Aetna requires documentation of the size of the hernia, whether the ventral hernia is reducible, whether the hernia is accompanied by pain or other symptoms, the extent of separation or rectus abdominus muscles, whether there is a defect (as opposed to mere thinning) of the abdominal fascia, and office notes (from your doctor) indicating the presence and size of the fascial defect.

From what I understand, it is possible to get insurance companies to pay for a panni (and/or hernia repair), and then you can upgrade to a full TT.

Good luck!