Question:
Comment: Why the PS Hassle with kaiser?

It is wonderful that Kaiser allows us to have the surgery however, they know the after effects of such a surgery with hanging skin, huge stomach, low breast, etc. It should not have to be proven through rash documentation etc. to qualify for post op surgery. The fact that you have hanging skin, huge stomach, breast etc. should be enough for them to grant corrective surgery. You gain self confidence in yourself from loosing the weight and it is taken away to an extent when you have to view your new hanging body. It is like going from one extreme to another, a tease so to speak. A smaller hanging body. How great is that. They need to change their policy. People who successfully lose the weight should be allowed to have the corrective surgery with no hassles! Thank You.    — sujoe (posted on June 16, 2005)

June 15, 2005
it would be the same justification that led to the laws mandateing ps for mastectomy patients. its the right thing to do.
   — walter A.

June 16, 2005
The reality of course is that these are large companies who are in business to make money. Weight loss surgery saves them future bills because the heart problems, diabetes issues, back problems, and joint problems that are expensive to treat are all cured by weight loss. Excess skin does not cause patients such serious future problems (nor does it cost them much to treat). Most plans state that "surgery to correct deformity resulting from disease" (i.e. breast cncer) is classified as "reconstructive" not "cosmetic." Why then are patients treated for morbid obesity not offered reconstrution? I point this contradiction out whenever they deny plastic surgery. Weight loss patients, in my experience, clearly do not want "beauty surgery," they just want to look more normal. Sorry for the soap box...but it IS the right thing to do.
   — DrL

June 16, 2005
I totally agree. Although admittedly, I may be a little biased since I just got my denial letter yesterday for my panniculectomy. The reason they listed wsa that I am not yet 18 months out. Well, since my insurance plan will be terminated on August 2nd, it's not difficult to figure out why they decided that. If I wait until I am 18 months out, I will no longer be a covered employee and they won't have to pay for it. Of course it doesn't matter to them that I have lost 160 pounds in just over 6 months and have been at this weight for about 6 months. I would still like to lose another 15 to 20 pounds but I cannot increase the intensity of my workout because of the hanging skin. It's not like I want this surgery to look perfect. I know I will never be asked to do a spread for playboy. I just want to be normal. I can't be anything close to normal with this. There are times when I think I was much more comfortable with all of my fat than I am now with this hanging skin. I feel like so much more of a freak. And I believe the insurance companies should pay for reconstructive surgeries so that we can feel at least somewhat normal.
   — Donna F.

June 17, 2005
Don't get me wrong me when you read this post. I'm not saying you don't deserve or shouldn't have corrective surgery... If I ruled the world, weight loss surgery and loose skin removal would go hand in hand and be 100% free to everyone who needed it. It's no fun to battle with the insurance company and even less fun to get a denial... I'm just trying to play devil's advocate and put some other ideas out there. It sucks to have to go through all the hassle to have loose skin removed... but there just isn't unlimited money to pass around. And I think it should go to people who need it for medical reasons before it goes to people who need it for non-medical reasons (and low self-esteem is not a life threatening condition). Life has lots of gray areas and it would be great if everyone who wanted a non-medically necesary but life normalizing surgery could have one. This is an extreme over-simplification but has the following occurred to you: Insurance companies have limited funds with which to treat patients... which is better?... weight loss surgery for two people *or* weight loss surgery plus reconstructive surgery for one patient (who is having no problems with hanging skin other than the appearance)? The goal of weight loss surgery is not to improve self-esteem (although it is a nice plus). Low self-esteem is not life threatening (qualifier: yes low self-esteem can lead to depression which can lead to suicide but in that case I think the money would be better spent in therapy than in the operating room). One person commented that: "Weight loss patients, in my experience, clearly do not want "beauty surgery," they just want to look more normal." The same argument can be used for women with small breasts, for example, who only want to look more normal. I'm not talking about going from a C cup to a DDDD cup.. I'm talking about sub-A cup to A or B cup. That person wants to look more normal too... Also, what about people with large noses/hooked noses/ridged noses... their goal isn't to look like the latest fashion model... it is to look more normal. An adult with deep pock marks resulting from severe acne in adolesence who wants a face peel or resurfacing... he or she just wants to look more normal too. The point is many people want to look "more normal"... if insurance companies start allowing non-medically necesary procedures, they won't have money for the medically necesary ones and that would be really unfortunate. If you've gotten this far and are pissed off at me, please go back and read my first paragraph. If I ruled the world, medically necesary would be defined differently and weight loss surgery would automatically come with excess skin removal and be 100% free... but unfortunately noone has elected and/or appointed me yet (or given me a key to the national treasury). As much as we want to demonize insurance companies for not paying for these surgeries, they do have reasons. And yes, you can argue that insurance companies are making profits off of us but that's part of life... I haven't met any practicing doctors who live in homeless shelters or who are on public assistance because they can't make ends meet. Maybe in addition to the insurance companies, we ought to get upset at the weight loss surgeons and plastic surgeons who charge so much money!!! Thanks, Sid
   — mrsidknee