Question:
Has anyone had the arms or breasts covered by insurance?

I am getting ready to start having some of my reconstructive surgery, and the first will be a tummy tuck next month. I am having a hysterectomy performed, so it will be a little less expensive. Actually, I am pear shaped and my stomach does not really have a apron to speak of; however, it looks like some terrible piece of wadded up fabric left to dry in the sun! Anyway, my breast and arms are next and in the past I have had really terrible fungus under my breasts. Would a letter from my doctor help sway my insurance in helping to pay for this? Unfortunately, we pear shaped people have to pay for everything out of pocket. At least you apple shaped people have a better chance of having your surgery covered, really I am jealeous because you also lose better and faster than us with the big thighs and legs! :) I am just looking for ways to try to be assisted with this undertaking. The tummy tuck will run about $3,500. I know my legs will also have to be done in the future. I am willing to continue driving my very old car to get this all taken care of, but, I was just wondering if anyone can suggest any measures that might help in getting any of my surgery partially paid for. Also, I heard if you are knicking your arms a lot while shaving, that an insurance company will consider this. Any comments are very welcomed!    — sheron H. (posted on March 17, 2002)

March 17, 2002
One thing for the breast reconstruction is to make sure your PCP is documenting the fungal infections. It seems to me that insurance will only cover reconstructive surgery of any kind if it is medically necessary. Don't know if they will consider the infections a sufficient reason to have it taken care of, but it can't hurt to try.
   — garw

March 17, 2002
Skin infections are usually one of the things that are used fo medical necessity when insurance is used for a breast reduction. It also depends on the size though. Do they bother your back? Do they leave grooves from your bra-straps? I had a breast reduction two years ago, and it was covered 100% and I was morbidly obese then and still am. If your chest is big after surgery, and still causing problems, it couldnt hurt to try to get it approved.
   — Michelle H.