panni question

Hello All

I am almost a year out and have lost more than I planned to.  I have some lower abdominal skin - not very much and am considering a panni

I was curious to know around how much this will cost - I have not looked into pricing yet and figured I'd ask fellow OH members that have had the procedure.

I am about 109lbs and 5'0" - I can honestly say I have about half an inch of skin maybe 3/4 of an inch - it makes my lower abdomen sag downward and just isn't pretty for me.  I'm sure I could live with it but for self conscious reason I am considering having it removed.  I am lucky to say from the belly button up I am happy with my body - my inner thighs sag a little but hey - can't have it all lol

I would appreciate any feedback - ALSO... was wondering if anyone with Federal BCBS has had a panni and if it was by any chance covered by the insurance - and if so how did you get it covered.

Thanks in advance

I am in NH and it is $8000 here.  I know my dr is trying to get my insurance to cover because of the amount of skin I have and I am prone to skin infections and tears.   I can take care of it but he wants me to "let it get bad" a few times to document the issue.  I am also going to a pain clinic because some extra curricular activities threw my back out because of the weight and movement of the extra skin.  I am approved for a breast reduction right now and hope to have that done by the end of February.  Good luck.  FYI I am 5'3" and steady between 155 and 160 for 3 years now.

Will insurance pay while you are still overweight though? I have to achieve 160 at 5' 10" for my insurance company to even consider it. 

Are you freaking kidding me ?  You don't know Sookie's body composition, amount of extra skin or other issues... Calling her overweight is ridiculous and VERY judgemental. 

 I am 5'4 and wear size 6-8, yet I weigh 160 - 170... Depends on a day, month or how much salty food I had.. And my body fat % is low normal for my age and body frame. 

My BMI is in high, but that number is so flowed that judging someone based on that is not very good idea. 

I am not judging, but I do know that any insurance company I have had goes by BMI chart, so call it archaic...but it is likely what she will face since it does not sound like she has a huge, hanging apron of skin tbat would override tbe BMI chart.

Insurance companies will approve panniculectomies under a WIDE variety of situations and I have honestly never heard of a single policy wherein the "medically necessary" criteria for approving the surgery specifies a certain BMI!  

Some people who were SSMO or SMO have an extremely large pannus that severely limit their mobility, and they have them removed even though they may still be SMO or MO. ( assume this is the scenario that someone else explained to you via PM.)

At the other end of the spectrum, you can have someone who is a normal or even underweight BMI and just barely meets the medically necesaary criteria because they have skin issues even when the amount of skin overlap is relatively small.

MOST people that I know who have had panniculectomies, however, fall into the middle ground category where they have not lost 100% of excess weight (whether defined by the BMI chart or just by visual evidence) but have issues because of the extra skin.  (If someone has been at a stable weight for THREE years, that is probably the weight they are going to stay at, and there is no reason they shouldn't have that extra skin removed.)  

I still had a BMI of 27 when I had my panniculectomy done. Even though it hung down onto my thighs, it was almost all just skin (only 6 pounds) and did not impact my ability to move.  I had terrible rashes, though, and still had to wear baggy pants and tunic tops to hide the sagging pannus (and mons) even after losing almost 175 pounds.  My insurance required that I have at least 6 months of documented skin issues that had not responded to OTC or prescription treatments, and that the pannus hang down below the pubic bone. I could have been at a BMI of 30 and met the criteria and it wouldn't have mattered to the insurance company.  (My surgeon would not have done it at that weight, but that is another matter.)

Lora 

My issue was you not knowing her and calling her overweight instead of calling her BMI in overweight category. There is a HUGE difference between those 2. 

With all due respect, everyone here is or was overweight.  Lighten up!

I don't think you should speak for everyone,. I am not overweight. And many are not either here.

There is a difference when we are post op and fit,  between being overweight and having  BMI in overweight range.  If you can't understand that then you may need to do more research. 

With such a small amount of extra skin, it is very unlikely that insurance will cover it. Most insurance policies requires that it hang down a certain amount AND cause rashes from the skin constantly laying on top of itself.

My excess skin hung down into my thighs, so insurance covered it, but a friend had what sounds more like what you describe and she had a modified version where, instead of a full hip to hip incision, hers looks more like a hysterectomy incision (about 6 inches wide just above the bikini line).  She was self pay and paid "around $5000". 

Lora