Question:
I had surgery 6/9/03 I started out at 340 lbs I am now 230 and I am a size 16 but due

heavy weight training I look smaller. My hubby had surgery on 7/28/03 he was 443 and is now 265 in only 9 months. The only loose skin we both have is the he has in the belly and he has a hernia. We both really need the tummy tuck. We both had surgery under bcbc of illinois ppo my job will be switching to united healthcare ppo next month. does anyone first of all know how to get the tummy tuck covered? How will the switching of insurance effect getting this covered, it is definitely reconstructive not cosmetic. Although we are not one year out my hubby is nearly at his goal of 250 he is 6'4 so we need to get approved now, especially with hsi huge hernia. If anyone has any information on how to get this covered please reply. Thanks!    — Lisa G. (posted on April 21, 2004)

April 21, 2004
Can't help you with ins., but just wanted to say we have the exact same stats. Same starting weight, same current weight, same size! I also do a lot of weight training.
   — mrsmyranow

April 21, 2004
If your switching to United Healthcare, it is much easier to get a tummy tuck if you have a hernia. I had United when i had my hernia repair and panni removal. Someone i know didn't get approval just going on the bases of tummy tuck. They have to see that it is medically necessary and with a hernia they have consider that necessary. Any questions feel free to e-mail me and good luck to you and congrats on the great loss!
   — Tammy N.

April 21, 2004
Most plastics are not covered but having a hernia can seriously cut the cost way down. I had my TT in February this year and it was also reconstructive but it is almost impossible to get it covered without a long history of physical issues caused but your overhang that you have had documented by a doctor. I ended up having a full abdominoplasty with muscle reconstruction and I stayed in the hospital for 3 day and payed $5000.- out of pocket. That was about 1/3 of the actual hospital bill. I would go for it with the insurance but I would know that I was in for a fight. If it goes easily more power to you. Good Luck!
   — Carol S.

April 25, 2004
I am havign my abdominalplasty June 17th and my insrance approved it right away and will pay for everything because I have 2 hernias but also I had documented about rashes from the overhang. It just depends on your insurance. Go to a plastic surgeon they will put in a letter to your insurance and see what happens. If it isn't approved you can appeal and lots of people can get it by appealing. I do not personally know anyone who has had to pay out of pocket.
   — lmonroeny