How long after vsg did you get it?

Did your insurance cover it?

How much did you pay?

How were the first few weeks?

How did you "treat" your scar?

.... ect.

I'll be watching this topic, since this appears to be my next step.

Hopefully we get some responses lol.

My question is if WLS is an exclusion on your policy things such as tummy tucks and breast reductions should be covered if they are medically necessary right? I figure if you develop a lot of loose skin, rashes, etc then it should pass for medically necessary?

My question is if WLS is an exclusion on your policy things such as tummy tucks and breast reductions should be covered if they are medically necessary right? I figure if you develop a lot of loose skin' date=' rashes, etc then it should pass for medically necessary?[/quote']

Tummy tucks at most often not covered because they include bringing your abdominal muscles back together. Skin removal due to rapid weight loss & breast reduction vary according to the specifics of your plan.

OTR sleever, I read a post somewhere on this forum where a lady said her insurance would cover a tummy tuck if the skin hung below your privates or something to that sort, it was said that it would be medically necessary due to increased potential for rashes, sores etc. I would have thought that a tummy tuck would be considered cosmetic but the explanation she gave sounded a bit reasonable. I can see the excess skin being a problem in that case. It would be great to have that covered. When I called my insurance co they stated that although WLS was not covered any problems/complications upon returning from Mexico would be. I'm gonna call an ask about skin removal or breast lifts and tummy tucks. I'm sure I might need one of each, lol!

I would greatly like to hear from anyone that needed this. I know the extra skin is bad and sucks but to make it to that point is a good thing. It takes alot of weight loss to reach that point and I am hoping to make it there soon.

Some how my insurance will cover and actual tummy tuck, with no diagnostic restrictions!! Woo. Only 83 more pounds to lose and i will be opting for this.

Some how my insurance will cover and actual tummy tuck, with no diagnostic restrictions!! Woo. Only 83 more pounds to lose and i will be opting for this.

Great! Did they cover your WLS?

Great! Did they cover your WLS?

Yes they did.

From what I have researched the procedure that is most covered for "medical reasons" (but not by all ins co's of course) is called a panniculectomy and is most likely what was on the referenced post of it being covered.

A panniculectomy is just removing the excess skin if it is causing medical issues, but does NOT include any type of muscle tightening which is the actual Tummy Tuck. So, most likely Tummy Tucks which remove and tighten ab muscles is not covered by many ins co's because that part is considered "cosmetic" not medically necessary.

I figured they wouldn't cover a tummy tuck, and would do the panni, but for some reason my insurance won't cover the panni but will do the tuck. Guess I'm just lucky.

Has anyone had tricare approve a tummy tuck or panniculectomy? I found something on the tricare website that said if it is medically necessary but had weird time restrictions. I went to the local tricare office and they told me it wasn't covered at all... Just love those people.

Has anyone had tricare approve a tummy tuck or panniculectomy? I found something on the tricare website that said if it is medically necessary but had weird time restrictions. I went to the local tricare office and they told me it wasn't covered at all... Just love those people.

Have you asked this question in the Military Spouses group? I too would like to hear the answer. At the seminar I attended they said that they can make a referral to plastic surgery but that tricare rarely covers it.

I have not asked them yet. I was going to get a consult with the plastic surgeon and see if he had any success getting it approved. I do have a bit of a panni but it is does not hang below... Their weird time restriction says that it must be done by December after the year of the surgery. Most surgeons do not reccomend it until after 18 months... I guess that is their way of not paying for it. If the surgeon tells me he has not had success getting it approved, I will wait until next summer. I figure the more weight off the better the outcome.

Khy

I asked my surgeon for a referral and they told me I need to be at a stable weight for several months. I am 2 lbs from my goal so maybe next year. My insurance will cover the panni if your skin hangs below you private areas or if you have alot of rashes, skin problems. I was told to document from the beginning any rashes. I had one pre-op and none since and my skin doesn't hang that low. My program has a body contouring program with the plastic docs basically each thing is around $6000 all inclusive - now a breast lift (6000) and enhancement (6000) is considered 2 different procedures. If you combine 2 procedures there is supposed to be some other discounts also. I know these things from a support group meeting where the plastics doc presented. I am looking forward to speaking with them. I also did some research on panni vs tummy tuck - if you have just one roll/apron of skin below your belly button only a panni can take care of it, otherwise the tummy tuck is the way to go. I didn't write down any panni info as I didn't think it would work for me but now know it will. Not sure if it is cheaper.