Excision of skin may be covered

I am having a LBL/BA/arms done in December with a whopping bill of $30,000 which will include the fleur des lis incision. My doctor submitted a predetermination for the excision of skin and today I called my insurance company and was told that although she can't confirm that it will be covered it does state that I meet the medical criteria!!!!! She said I should know for sure in a week.

Since I meet the criteria I am guessing I will be approved for it.  My question is, what does excision of skin cover?  Is that the pannectomy?  I realize that may be a dumb question.  Also, if I am lucky enough that it is covered, how much do you think that would reduce my $30,000 bill?

I am in Ontario Canada so really I think our rates are different. Here, if my panni wasnt going to be covered I would be paying $7000.00 for an upgraded panni to a full tummy tuck. Our OHIP program (it's a government insurance program all Ontario residents get) approved the panni so my full tummy tuck is now only $5000. So I guess its about a three thousand dollar savings? 

I was quoted by another plastic surgeon that if my panni isn't approved by OHIP it would add $1500 to his fee. 

Hoping yours is approved and that it helps lower your procedure rate 😄👍

Annette 

I was told that if insurance OK'd the panni I could expect to see $1250 deducted from the $14,00 bill. Seriously?  Does not seem fair when you consider surgeons fees, OR time and anesthesia.

It's probably referring to the panni only.  My guess is that the reduction would be a couple of thousand.  Hey, every little bit helps!

Thank you guys for responding.  I'm keeping my fingers crossed it is covered and will be a significant savings.  After hearing from y'all I'm not getting my hopes up though. 

The insurance coverage really depends on the individual insurance companies and their criteria as well as the plastic surgeons and your input! They usually will tell you what part they will cover. Unfortunately, we have had the experience that they reverse their decision AFTER the procedure. Keep all your documentation and keep appealing it,through your plastic surgeons office, to obtain as full coverage as you can.

Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery 1441 Avocado Avenue, Suite 307 Newport Beach, California 92660 949.640-6324/1.888.234-5080(Ca) Website: http://www.surgery-plastic.com Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine) Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors Plastic Surgery- 2005/2006/2007/2008/2009/2012/2013 President,American Society of Bariatric Plastic Surgeons www.ASBPS.org

Non-Toxic, No Nanos Skin Care- www.ORGANODERM.com

Scar Therapy-www.ScaRxtape.com

Thank you to all *****sponded. I was out of town and am just getting back. I heard from my doctor's office and it did get approved and it looks like it will save me $3,000.  Unfortunately,  I still have to pay$1,800 to meet my deductible so the savings aren't much.  I will definitely keep good records and document everything incase they try to back out of paying after the fact...great advice!