O-M-G!!! LOVE my HMO!!!

I just got a letter of approval from my HMO for plastic surgery.  They will fully cover (ok, except for the copays which, other than overnight hospital stay have already been paid) circumferential abdominoplasty and buttocks, thigh lipectomy, arm lipectomy, and breast reduction (of skin).

I am totally in shock - we thought they'd ok the panni and MAYBE the breast reduction (due to torn chest wall muscle), but we NEVER thought they'd cover anything else, let alone all of it!

I've got a call in to the plastic office scheduler to make sure that's really what it says, and start making plans for having this done.... I'm in shock!

On the other front, I have gained a pound! Yayyyy!  (I know - weird, isn't it?  I never believed that I'd ever consider saying such a thing.  But I'm doing it slowly, that one pound took a week to gain, and I'd like to add 7 more to it and then stop).

I hope it's all true!! That would be awesome!

--gina

Congrats!!  that is awesome!!

Congrats!!!    WOW...I'd just be happy with my tummy done.  How did they submit it?  What insurance do you have?

That's where we thought we'd be - and then self-pay for the rest!  They submitted via regular protocols, but I did have my PCP and the breast specialist who diagnosed the chest wall muscle tear last spring send letters of verification of the issues I've had (skin sticking, scarring where things hang and fold, that sort of thing), and then photos of the shar-pei look of all the skin.  It probably helped that bones were sticking out, making the skin look even worse.

My insurance is Blue Cross Blue Shield HMO Illinois - but it's through the teachers' union, and is fabulous insurance.  That's combined with having a wonderful medical group: walk in appointments, weekend hours,choice of 4 highly rated hospitals, much consultation/conferences between specialists and PCPs, all the good stuff.   I know, after reading through the new health care bills (and yes, I mean the legalese of the laws themselves - it's sloggy work!) that I'll either be taxed heavily for having a "cadillac" policy and have to move to something else, or my policy will be gutted.  That's one reason we started looking into plastics so early out.  Yes, I've lost all my excess weight (and a bit more), but we wanted to be stable longer before going here.  However, I had enough scarring and problems that, along with the changes coming for my policy, it was time to look into it now.

Congratulations on getting the approval.  Keep us posted and let us know when you have a date.
Linda

Actually, we set a preliminary date a month ago when I had the first consult - ironically, it's 12-16-10.  A year to the day after my RNY.  We may move it up a couple days or back a couple days, but it's pretty much set for just before winter break so that I can recuperate over those 2 1/2 weeks.  Since there's no lipo to do, and only the one muscle issue in the chest wall, the estimate is that I can go back to work with lifting restrictions after 2 weeks.  And if I'm too tired or sore, I go in for a day, then take a couple more sick days.

 WOW Rebecca!  This is just so awesome!  Congratulations!!

 With SINCERE CONGRATS!!!! Looks like these big Insurance companies are finally trying to work with it's "people"!!!

I wish!  I think it's more that my actual insurance underwriter, the teachers' union, has enough members and clout to have insurers write policies that will benefit their members and keep them healthily (is that a word?  Well, it is now!) for more years.  Insurance companies only write what the companies paying them will pay for.

But whichever, I'm SO GLAD I took the HMO!  The doctors have told me that it's far easier to work with than the PPO (also BCBS-IL) is.