HELP! I'm in S. California... "BOOBS" I need help with my insurance to pay....

YummyMummy1
on 2/9/13 2:33 am - Hawthorne, CA
Hi there!
I am in Southern California next to LAX. I've had RNY in Summer 2008 and TT in Summer 2010. I have lost a lot of weight and when my surgeon submitted my TT paperwork in 2010, they ONLY approved TT, not my boobs. Very sad to see that. I didn't know how to appeal to the letter. Now I am determined to have my boobs done, but now my job changed us to AETNA HMO (in July 2013, I will change it to PPO). I think it would be easier to have it PPO.
I seriously need a BREAST AUGMENTATION and IMPLANTS. Has anyone had my insurance and had this procedure done? HELP ME! I get rashes and I am constintely feeling like a smell wierd from under my boobs. It's driving me crazy.
Any doctor's in Beverly Hills?
I am going to go to a consultation and I hope they can help me and submit something.

HELP with information.

YummyMummy1

    
sonnieN
on 2/9/13 4:31 am - grand rapids, MI

I have never seen any insurance pay for an augmentation and implants. Only thing I've ever heard of insurance paying for is a reduction due to medical reason. A lift w/ implants is always considered cosmetic and not medically necessary. Best start saving your money if they really bother you that bad or invest in some good supportive bras.

godzilla
on 2/9/13 6:22 am - Israel
Okay: from what I've reas of others - find out what your insurance plan at present covers by looking at it's manual so you can learn how to fight for what you deserve.
Document rashes and odor by talking to GP/PCP and skin doc as well as if you have shoulder/back pain by orthopedist to verify medical need for breast surgery and a PS will write up what is best needed for your body.
Photos won't hurt and I believe a personal letter stating why you need this procedure.
In my situation I know I won't he a Barbie or a Twiggy.
Plastics after weight loss does not usually cause aperfect shape or model's body but a more normal body which for many formerly obese,morbid obese,etc. - any plastic reconstructive procedure enhances and improve appearance.
Mikimi in Isreal
 

brightiz69
on 2/9/13 11:08 am - California City, CA
I have kaiser in so cal. They covered my tummy tuck, breast reduction and lift. I have migraines so it was covered. Implants kaiser won't do though.
Robert Oliver
on 2/10/13 2:51 am - Birmingham, AL

A lift with implants (as you describe) is not considered reconstructive and would not be covered by insurance.

on the web at Plastic Surgery Specialists

blogging on all things plastic surgery  at Plastic Surgery 101
Iam_with_the_Band
on 2/12/13 4:45 am

breast augmentation and implants is redundant, do you mean breast lift and augmentation? some insurance will pay for a lift to  rashes but o  will pay  augmentation, that is considered cosmetic unless you had a mastectomy. calling your insurance is the only  to find out if they will pay for a lift.

12/09 and 6/11, 9 skin removal procedures with Dr. Sauceda in Monterrey Mexico
Revised to the Sleeve after losing 271 lbs with the LapBand. 

Most Active
×