Question:
Can insurance be bought..............

i live in nyc brooklyn to be exact i had an open rny on 2/26/02 and so far i have lost 91 pounds. i was told that medicaid which paid for my (rny) will not pay for reconstructive surgery which is concidered plastic surgery if not looked at from the aspect of it being needed as a direct result of gastric bypass. now is it possible to buy insurance? if i do buy it can i keep it just until the proceedure is taken care of? or would i have to commit for a period of time? i would like to have a tummy tuck and breast lift, and also what insurance did you guys have that covered any of these two proceedures? and what was the steps taken to have it approved    — Latisha M. (posted on November 1, 2002)

November 1, 2002
Hey, You're in sort of an awkward spot. The reason for that is it would only be beneficial for you to purchase insurance that definitely covers reconstructive plastic surgery. In order to know that a policy definitely covers it, you are going to have to ask before you purchase. This will send up a red flag. Additionally - if you are purchasing insurance as an individual and not as an employee benefit at open enrollment, you will most likely have to have a physical prior to being given a policy. Unfortunately if you are not an employee purchasing insurance immediately upon hire or at open enrollment that will mean your need for a tummy tuck (panniculectomy) and breast lift would be considered pre-existing and you could have to wait as long as 18 months for coverage. This will result in you having to pay a whole lot of money for insurance - maybe even more than the plastic surgery would have cost you. I'm not telling you this to discourage you. I'm hoping that you might be able to pursue this from another direction. If you have hygiene issues and/or rashes from the apron of skin hanging on your abdomen and your physician or surgeon documents it you may be able to get coverage through medicaid if it's considered medically necessary. That's how I'd pursue it. Purchasing insurance as an individual can be so expensive! Also, as far as getting a breast lift - you'd be better off trying for a reduction if you have enough tissue. I know there are people who get insurance approval for lifts but far more are turned down as this is almost always considered cosmetic. A reduction due to back pain, bra straps indenting your shoulders, etc. is usually a medically recognized condition. Best wishes to you - I hope you find a way to work it all out!!!
   — ronascott

November 1, 2002
I met a lady last year who (with her mother) (and a year before then) had self payed their RNYs. She was on state medical last year and told me that the state would be paying for her tummy tuck. It sounded to me like as long as she could prove medical necessity that it was covered. On the issue of pre existing conditions. I'm wondering if since you're on state medical insurance if, just as if you had another group or individual policy up to the point of your new insurance, if that exempts you from that clause. It would be worth checking into seriously before you went to the trouble of seeking an individual policy. I'd really check into your medicaid benefits first. I think if you take another policy on your own that they will no longer cover you. Something to definitely check into as well.
   — Shelly S.