Question:
What did your benefits booklet say specifically that let you know that PS was covered
Mine says under covered expenses Cosmetic surgery to correct damage from injury or illness.Would that cover TT and breast lift following WLS? — Lisa F. (posted on May 23, 2003)
May 24, 2003
Hon,
There is only one way to find out - try and see. My insurance said that
reconstructive surgery was covered but not cosmetic surgery. I had to have
hernias repaired and needed a tummy tuck. They approved the hernia repair
(for day surgery) and denied the panniculectomy. My surgeon called the
doctor who denied it and got a verbal approval over the phone. That was on
a Friday afternoon about 4 PM. I had surgery the following Tuesday at
noon. Well, the insurance has paid the hospital bill (and I was in the
hospital from Tuesday until late Friday afternoon) and the surgeon for the
hernia repairs but so far they are refusing to pay for the tummy tuck,
saying that it is cosmetic. Luckily for me, the surgeon who did my RNY did
this procedure too and he has told his office manager to tell me not to
worry about his bill - he just wants to make sure that the hospital got
paid, which they did with no problem. So who knows.
Patty
— Patty_Butler
May 24, 2003
Sounds like it does cover it. Your illness was morbid obesity and it did
cause damage. But as the previous poster said, there's only one way to
find out. Call and ask. Good luck to ya!
— roryleigh
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