Question:
What do they pay for? TT,breast lift, arms, chin??????

I had LAP RNY on 8/8/01. I now weigh 163 pounds. I have large panni. Starting to look into TT,Breast lift,chin,arms. What will BC/BS FEDERAL pay for? What co-morbilities did you use? How long did you have to wait? Trying hard for infomation. Please Help if you can.    — Gail R. (posted on May 30, 2002)

May 29, 2002
I've had insurance pay for reconstructive surgery for my brachioplasty (bat wings), mastopexy (breast reduction -- same as lift but insurance covers), TT, inner thigh, lower body lift (w outer thighs). Insurance did NOT pay for my chin lift (lower face lift), eye lift or implants as they are considered cosmetic surgery (they are also much cheaper than than the reconstructive removal of redundant skin. I have never hear the word "co-morbitities" used for plastic surgery. I think you are still thinking about approval for WLS. You probably mean "medical necessity". These surgeries are entitled to coverage based on the ASPS position paper stating, in brief, that they need to make us "look normal" -- exactly as they are required to do breast reconstruction after mastectomy. You should be able to find this paper in this library, the OSSG platic surgery list site and the ASPS web site. I also had a government insurance plan with good coverage. But the actual amount covered is dependent on what arrangements YOU make with a PS and what amount S/HE will accept. I only had to wait 48-72 hrs after claim was submitted for verbal approvals.
   — Jill L.