BCBS Federal- will they cover anything?

P. Poster
on 3/13/13 1:41 pm

I am almost 3 years post-op DS, and have been weight stable for about 1.5years.  I am ready to start looking into plastics, and have had 2 consults here in the DC Metro area.  OMG, it is so insanely expensive!  There is NO way I can pay for it, not even on credit.  I just cant allocate that much money.  Im a mom, saving for college, trying to get by, Sequestration, blah blah blah, I know youve heard it all before.  I need a full LBL, inner thigh lift, breast lift and aug and brachioplasty, but am willing to "settle" on just a "mommy makeover" with mons lift at this point.  In any case- to my question.  I have BCBS Federal.  Will they cover anything?  At all?  If so, what do I need to do to make it happen.  Any and all help, very much appreciated!  

Laura in Texas
on 3/13/13 9:41 pm

Not sure if they will or not. Some insurance companies need documentation from your doctor about rashes. Look at your policy.

I'm a single mom of 2 (with no baby daddy) living on a meager salary. Mentally I had to get it done. Where there is a will, there is a way.

Look into residency programs in your area.

Laura in Texas

53 years old; 5'7" tall; HW: 339 (BMI=53); GW: 140 CW: 170 (BMI=27)

RNY: 09-17-08 Dr. Garth Davis

brachioplasty: 12-18-09 Dr. Wainwright; lbl/bl: 06-28-11 Dr. LoMonaco

"May your choices reflect your hopes and not your fears."

emelar
on 3/14/13 12:05 am - TX

I have BCBSFed and I didn't even try. There's an exclusion for plastics unless medically necessary. So I suspect the most you could get approved is a panni, assuming you can document medical problems, like rashes, being caused by it. 

bamabelle16
on 3/14/13 12:54 am
I live in Nova, and I tried but they would not cover anything.
Angela B.
on 3/14/13 8:13 am, edited 3/14/13 3:12 pm
I have BCBS Federal and they paid for the front portion of my lower body lift and I paid the difference. When I called and asked about covered benefits, they told me panniculectomy and abdominoplasty were both covered benefits, but thighs, butt lift, and arms were not. The more difficult part was finding a plastic surgeon that would accept insurance as payment. After I found a doctor, I got the approval letter from BCBS in about a week. My total lower body lift with lipo to the outter thighs cost me about $8K, instead of the $15K it would have cost without insurance help.
                    
K. L
on 3/22/13 12:32 am
RNY on 08/20/12

Angela- how much documentation did you have of rashes, problems, etc. for BCBS Federal to pay? Did you have to submit pictures? Any additional information you could provide would be great!

Angela B.
on 3/22/13 1:39 am

I actually never had a rash.  A plastic surgeon submitted a letter to my insurance company stating when I had surgery, how much I had lost, and a list of treatments I had tried for chronic back pain (months of physical therapy, acupuncture, steroid injection, about a year of chiropractor visits).  She also took pictures and submitted them to show the excess skin.  That was it.  A friend of mine also submitted her request to federal bcbs, and she was also approved within a week, and she had never had back pain or a rash.  The federal program criteria are different than your state bcbs, and the only requirement they have is that you have a doctor say the procedure would be medically necessary.  

                    
jinjer
on 3/15/13 12:27 pm - Eastwood, KY

I had a lower body lift. They approved and paid for the panni, they paid $1850 of the $5000 my doc submitted. 

 

Jinjer

P. Poster
on 3/16/13 2:15 am

Thanks all!  My surgeon is submitting to have the panni covered- which would also cover the surgical suite, anesthesia and 2 night hospital stay.  Im prepared to pay in full, but if they decide to cover any of it, it will just be a bonus.  Surgery is scheduled for April 23rd :)

1SushiDiva
on 4/28/13 5:37 am - MD
I just had a pann done 5 days ago through BCBS I went to dr. Shureih in BMore he arranged it all. The ins paid for the skin removal I had to pay the rest.
      
        
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