What determines medical necessity for abdominoplasty?

I have BC/BS with the State of Maryland; according to customer service, they do not give approval for plastic surgery, instead they say that it has to be medically necessary. So the surgery would be preform and then submitted for approval and payment. Of course, no Plastic Surgeon will take that chance and no get paid. (I can understand the PS position). What BC/BS is not saying is what requirement must be met for it to be classified as medically necessary. I keep getting the run around concerning this inforamtion. Added to this is that I am currently scheduling GYN surgery and wanted to have both done at the same time.

We greatly appreciate your interest in helping us build our Q&A database. To discourage vandals from posting garbage, however, we require people to register before posting.

You must be logged in to post an answer. Click here to log in.