excess skin removal

I had a RNY gastric bypass on August 5, 2011. I have lost over 120 pounds. The scales tell me I have lost weight, but I have so much "excess skin" I feel like I never had surgery. My insurance covered the entire cost of the bypass, but they consider skin removal to be cosmetic, and will not cover any of the cost. I have 2 questions:

1) I live in Lafayette, IN. Does anyone know a doctor that will "finance" my surgery for the skin removal in this area? (Indianapolis included) I have about 2,000 as a down payment.

2) I have been told that doctors can "word" the skin removal process in such away that my insurance will cover it. Does anyone know of a doctor in my area will do this?

I sincerely appreciate any help you can offer.

Thanks, Janet

Hi Janet,

I live in your state. I don't have the information you are looking for but I have heard that some bariatric programs have connections with surgeons who are skilled in removing and contouring post bariatric loose skin. Do you still see your surgeon who did your surgery? Do they have any information or resources for people they may network with?

Usually the way for insurance to pay is if you have rashes, infections or the excess skin in effecting your quality of life. You need to have back up documentation with either your Bariatric Doc or Primary care. So start complaining and getting medications if you have those problems.

I am sure most surgeons have a finance program, many Docs participate in Care Credit, which when I used for dental work gives you interest free if you pay it off in a year.

I highly recommend using someone experienced with massive weight loss, I always say the quantity and quality of our skin is different. It was a good suggestion from the other poster to contact your Bariatric Surgeon and see if they have anyone they recommend.

Regarding point 2, some folks are able to get insurance to cover it due to medical necessity if they have trouble with rashes and infections on the loose skin. I would be VERY wary, however, of a doctor who fudges the wording to get your plan to cover it-- that's insurance fraud!

I recently read a study about post-bariatric folks and how having plastics statistically helps to minimize the incidence and degree of regain, as opposed to the statistical incidence and severity of regain amongst those post-ops who didn't have skin removal procedures. In that study, there was a clear health advantage shown in the group which had had cosmetic surgery done.

Perhaps some day post-WLS plastics will become recognized by insurance companies (or whatever system we may go to) as reconstructive necessity rather than a vanity project, especially if bolstered by statistics showing improved outcomes. Also, while of course docs should not lie about the severity of any patient's need for any procedure, most docs are bright enough and care enough to understand the system and to try to help the patients in their care to receive the help they actually do need. Presenting individual cases in the most helpful light doesn't constitute fraud so long as there is no lying, at least in my book.

I agree that skin removal can be great for the folks who need it!

I think that ultimately one just needs to watch for the difference between a doctor saying, "Extra skin impedes quality of life and this should be covered" versus a doctor encouraging a patient to rub their skin with sandpaper or complain about nonexistent rashes to get coverage (both of which have shown up here on OH!). :)

Yes, of course, I agree. Not to mention that rubbing your skin with sandpaper is a terrible idea!

Thank-you to you all *****plied to my post. I appreciate it very much!! Janet