Question:
Hhow much excess skin do you have to have before they will consider sugery?

When will Insurance cover. BCBS personal choice.    — teresa M. (posted on March 1, 2003)

March 1, 2003
First, all BCBS policies are different. Now that I've said that, I just had a panniculectomy (tummy tuck) and the doctor removed about 5 pounds of excess skin and tissue. Personally, I was a little disappointed because he said it would be between 15 and 25 pounds. But I am not displeased with the results even though I would have like to have been a little flatter. But according to the BMI charts, I'm still obese. I have lost 171 pounds (including 11 since the tummy tuck) in 15 months and am very pleased. I am 56 years old and my surgeon didn't want me to lose below 200 (I'm now at 175) because my face is very thin and he thinks that if I lose much more, I will look bad and feel bad. I have lost roughly 80% of my excess weight and I am thrilled. I lost 160 pounds in about 10 months. I certainly don't look like a 20 year old model, but I am at least "normal" looking now. You will need to check with your insurance company about their requirements for considerting the skin removal medically necessary. Mine (Empire Blue Cross) denied it at first as cosmetic, but after my surgeon spoke with their doctor, they reversed it. Good luck to you.
   — Patty_Butler

March 1, 2003
It's not really an issue of *how much* extra skin you have with most insurance companies. It's an issue of whether you can prove the removal of the extra skin is medically necessary. Typically, you will need to prove with the concurrence of your doctors, that it is causing uncontrollable skin problems (rashes), or pain of some sort, and that it cannot be controlled in any other medical manner. I think the one exception here is breast reduction surgery, and if there is a certain amount of breast tissue to be removed, then that is a qualification for the surgery (not sure what it is - 500 cc??). In my case, I went through multiple appeals proving that I had suffered from some pretty severe back pain and had taken a number of other steps to try and resolve it, including medication and physical therapy. -Kate-
   — kateseidel

March 3, 2003
Have the doctor take a side photo of you pulling all your excess skin out. This REALLY shows how much excess skin you really have. I was approved the same day once the insurance company saw that picture.
   — Patty H.