Question about Tummy tuck

Hi everyone,

I'm six years post op Lap Band with Anthem Blue Cross Blue Shield of Virginia.  According to documentation found on their website to be medically necessary the panniculus must hang below the level of the pubis.  In trying to do some research it looks like some patients are standing in their pictures and some patients are bending over.  From my best uneducated guess, the pubis is about where the pubic hair is.  When I'm standing, my excess skin does not come over my pubic hair.  However, when I bend over, ALL of my girlie goodies disappear!  I also have a large overhang at my belly button. 

For those of you that have been approved through the insurance, what did your PS tell you about insurance approval?

My stomach is not as bad as some but it prevents me from doing some things.  I'm a distance runner and have a difficult time during the warmer summer months with long runs because of chafing and skin rashes.  

Any advice or shared experiences would be appreciated.

They mean extending down past the pubic area (think very top of your thighs) when standing upright.  If you want to give insurance a try, start documenting the rashes and chafing with your doctor, including pictures.  But the most you're likely to get covered is a panniculectomy, which will take care of the overhang, but not the skin at and above the bellybutton.  For that, you'd need the full tummy tuck.

Different insurance companies have different criteria. We routinely take photos and send these in with a history of medical problems associated with the hanging skin, like difficulty ambulating, various skin problems. We do this also for our out of town patients. It definitely should be done prior to scheduling. Our Society, the American Society of Bariatric Plastic Surgeons is continuing to lobby for insurance coverage of these procedures. I am President of this organization at this time.