Question:
Upper Arm Reduction coverage from BCBS of Alabama PPO

I am in the process of having a Panniculectomy approved. Is there anyone that has an UPPER ARM approval. I have been told it is just about impossible to get arms approved thru BCBS of Alabama PPO. My arms are so big I have to wear a shirt that has 3/4 sleeves. Don't get me wrong. If I can never have this procedure done I will be able to live with my body hanging. WLS saved my life. I am so gratful that BCBS paid for my WLS. I just don't understand why the arms are not covered. I have back pain and have to prop my arm on the wall when I blow dry my hair. I have lost 136 lbs since my surgery last August 2, 2002.    — mickie5535 (posted on August 3, 2003)

August 3, 2003
i was denied and 2 times for my arms. i am having abdominoplasty and my arms done on thursday. i had to pay out of pocket. the dr is charging $1200, then i'll have to pay the hospital and anestelogist (?).
   — candymom64

August 3, 2003
I just had upper arm reduction (i.e. brachioplasty) and was denied twice through BCBS....they said they 100% consider it cosmetic. I've known a few people who had it done while they had another covered procedure and they ended up paying $3,000 out of pocket.
   — Lynette B.

August 5, 2003
I've lost 115 lbs since having surgery on 4/22/02. I have 4.5 inches on skin haning on one arm and 5 inches on the other. I have just been approved by both my insurance companies (BCBS of Illinois)for an arm lift. At first my PS said I had a better chance of getting a tummy tuck approved than an arm lift. At first he didn't want to deal with my insurance at all. What convinced him to work with my insurance companies was that I did all the work, and went into his office prepared to convice him. All my PS had to do is write a letter that I attached with the price ($6,000) and that he agreed that I needed it done. I wrote a 3 page letter explaining why I needed this RECONSTRUCTIVE surgery. I attached pictures with measurements, and attached an article by the American Plastic Surgery Assoc. about how people who loose massive amounts of weight need reconstructive surgery, and an article about the difference between plastic and reconstructive surgery. My hubby's inusrance approved right away and mine denied me. I took all my paperwork, and sent it back to my insurance with the approval from my hubby's insurance, and an appeal letter. I explained that in the long run it would cost them much more money for doctor visits the hanging skin would cause mr. It worked and now they have approved me. When you appeal they send it to a panel of doctors who agreed with me. I see my PS in two weeks to set a date for surgery. I plan on having the surgery in the fall so I can wear long sleves. Feel free to e-mail me and I'll send you copies of my letters ([email protected]). It may take a little longer but if you want it bad enough, and fight for yourself you can win. Good luck to you!
   — Donna W.