Question:
Has anyone had to appeal plastic surgery denial and won?

I am actually doing a little research for a friend. She had WLS in October of 99, and is now ready for plastic surgery. Unfortunately her insurance changed in the middle of her weight loss journey, and her new insurance (Healthnet) has denied her plastic surgery, even after they approved her initial consult for a TT and breast lift. (He's even in network) They say it's not medically necessary and is cosmetic. She has lost over 200 lbs and has a lot of excess skin. I was wondering if anyone out there had a similar experience, or had to appeal in order to have their plastic surgery. I would be interested in seeing any appeal letters, etc. to get the ball rolling for her. She is coming over to use my computer to do some research tomorrow, but I thought I would see if I could get a head start. I appreciate any and all information! Thanks in advance.    — Kim B. (posted on September 11, 2001)

September 17, 2001
Hi, I was just going over past posts, as I'm recovering from my tummy tuck on 9-5-01. I was denied by my insurance, then appealed and won on appeal. I'd be happy to share my letter with you. E-mail me privately. Good Luck.
   — Lisa F.