Has anyone gotten insurance to pay?

[txaggiemom 0]

I am only 3 weeks out, but I was wondering has anyone on this board acutally gotten insurance to pay for their plastic surgery. I know I am going to need a Tummy Tuck and a boob lift. I was self pay for the surgery but I have heard and read that if you go to the doctor and have it doumentated for rashes that they might pay.

I was just wondering if anyone has actual experience with that working. If so I am going to start making appointments with my primary care doctor know because it is always a problem.

[Tiffykins 672]

Our insurance is a little different. We have an old style HMO, and yes plastics can be covered if medically necessary. I will be able to have Tricare pay for a Tummy Tuck. I started having my PCM skin irritation on my lower abdomen in January of this year. I have some pretty deep stretch marks from my pregnancy almost 12 years ago, and that skin is the most sensitive. I do not have on going rashes, or boils of any sort, but documentation is the key.

Although, I have zero personal experience at this time because I'm not seeking plastics until we have another baby, I have 2 friends down here that had their panni removed and covered by Tricare, and they personally paid the plastic surgeon his fee to do a full tummy tuck and some Lipo. Tricare covered all the OR fees, anesthesia, hospitalization (1 overnight stay), and other fees associated with the surgery. One of them had implants done at the same time, she paid right around 7k for the full TT, lipo, and implants. The other only had to pay around $1500 or $1600 for the TT and lipo she had done. Both of their procedures were performed by a civilian surgeon. There are a lot of requirements that have to be met for our insurance to cover plastics. Typically, we have to go through a few psych evals, and counseling to ensure that we "need" them in addition to the physical ailments that come with excess skin.

[mb20mom 9]

We were told during the Options classes that Kaiser will pay for a panniculectomy if the PCP approves it due to rashes. However, I've heard that those can be pretty ugly since there's no tightening done. Basically sounds like they just cut what hangs and staple you back together!

[mswendy 0]

My pcp just said to me the other day, when I went to her for a pre-Mexico visit - she has this other patient that had WLS and the doctor is documenting monthly all the terrible rashes this patient has. I told her I felt a rash coming on under my rolls (I'm not even sleeved yet) and she said "so do I". I said oh, i also feel one coming under my boobs. She said "so do I" and then we laughed.

I'm hoping to pass this through insurance, but we'll see. I know I'm going to need surgery for all the loose skin.

[Donna4545 13]

BC/BS ND pays for the pannus but if you want the muscles tightened you have to pay for that part of it.

[InProgress 3]

When I was researching banding a few years ago, I heard that my insurance, Highmark BCBS (formerly Mountain State BCBS) will pay for some things with the proper documentation even though my policy says no plastics. I have just recently started on my sleeve journey but have made a point of mentioning rashes under my breasts and fat roll for future reference. Like Tiffykins, however, I'll wait both for final weight loss and the possibility of future pregnancies to explore it fully. I just figure it's never too early to start documentation.