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Federal Blue Cross And Plastic Surgery

DanaInNewOrleans

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DanaInNewOrleans    513

DanaInNewOrleans
Posted

Anybody have any experience with Federal Blue Cross and plastic surgery after weight loss?

Do they pay? I hear that they do pay for quite a bit of it but I'd really like to know from someone who had it rather than from third party sources...

I know I'm getting waaaaaaaay ahead of myself here since I haven't even had my surgery yet but I really think knowing I can finally look normal (for the first time in my life) would be a huge motivator to me.

When I lost 160lbs( I've gained back 60) 12 years ago I was sagging skin everywhere--EVERYWHERE! I was very disappointed that I was still disfigured. I hate to admit this but my husband has never seem me naked with the lights on. He likes to joke by saying he gets glimpses of different parts and then just puts them together in his mind like a puzzle! lol... yes, he is a saint! But I would love to feel comfortable enough to be more at ease. The idea of plastic surgery gives me hope!

Sorry if I've shared too much TMI.....

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Livinglifeout    217

Livinglifeout
Posted

They used to pay for it, not sure if they still do with all the insurance changes. My friend used Fed Blue Cross for Tummy Tuck after her Gastric Bypass Surgery:)

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Saltmistrose    24

Saltmistrose
Posted

Hi there:

I would like an answer to this question as well. I will probably have my surgery in mid November or December. I am a Federal retiree that now lives overseas in New Zealand. I have had to use my private health insurance to get my sleeve surgery covered. I am too old for the public medical scheme to cover me here. I am 56 years old and they think less likely to benefit from the surgery, than someone younger (under the age of 50). I hope someone has an answer for us. Take care and good luck.

Karen

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KBT    35

KBT
Posted

Here is the benefit brochure for 2013. The only thing I could find is on page 62 where it says they will pay for surgery to correct a functional defect. Further down, it says Not covered:

Cosmetic surgery – any operative procedure or any portion of a procedure performed primarily to improve physical appearance through change in bodily form – unless required for a congenital anomaly or to restore or correct a part of the body that has been altered as a result of accidental injury, disease, or surgery

My guess is that plastic surgery may be covered if you can prove issues with rashes, sores and so forth.

http://www.fepblue.org/downloads/2013-service-benefit-plan-brochure_100512.pdf

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Holly5.3    423

Holly5.3
Posted

Here is the benefit brochure for 2013. The only thing I could find is on page 62 where it says they will pay for surgery to correct a functional defect. Further down' date=' it says Not covered:

Cosmetic surgery – any operative procedure or any portion of a procedure performed primarily to improve physical appearance through change in bodily form – unless required for a congenital anomaly or to restore or correct a part of the body that has been altered as a result of accidental injury, disease, or surgery

My guess is that plastic surgery may be covered if you can prove issues with rashes, sores and so forth.

http://www.fepblue.org/downloads/2013-service-benefit-plan-brochure_100512.pdf[/quote']

I wonder if having C-Section deliveries qualify as "as the result of ..surgery". Both were necessary for both of my daughter's deliveries. I've lost weight before and the stomach is still such a mess (my husband is also a Saint!). Ill do all I can to minimize sagging skin but for me surgery is the only thing that will do the trick. My sister who has always maintained her weight even had a TT and BA when she was done having kids. Like me the sagging breasts and belly were affecting her self image and her marriage.

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ashleyc    10

ashleyc
Posted

I was approved TODAY for the panni part of my tumny tuck! I went to my pcp 1 time for "rashes" that i never really had. My ps sent in the pics they took of me and the office report from my pcp and i was approved super fast. Fep Blue is really the best! GOOD LUCK!!!

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LovelyPea    16

LovelyPea
Posted

I was approved TODAY for the panni part of my tumny tuck! I went to my pcp 1 time for "rashes" that i never really had. My ps sent in the pics they took of me and the office report from my pcp and i was approved super fast. Fep Blue is really the best! GOOD LUCK!!!

OMG I'm so happy for you!!! Keep us posted!

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KBT    35

KBT
Posted

Ashley, does this mean FEPBlue is covering the portion of the Tummy Tuck that removes the panni? That is great!

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fallingwhisper    187

fallingwhisper
Posted

That's awesome! I found out today that aetna covers the panni surgery too. It's good to know we'll be covered when we need it

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KBT    35

KBT
Posted

That's definitely affordable! I need to get to the doctors to start getting my saggy tummy recorded!

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E-girl    98

E-girl
Posted

KBT yes!! My portion of payment will be $1800

I went to a plastic surgeon today and they use FedBCBS and he said that he has never had much sucess with getting it approved. Are you using a plastic surgeon? Are you only getting panniculectomy (the skin removed) or are you having an abdominoplasty (ad work, Lipo, etc.)?

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sheetmetalgirl    25

sheetmetalgirl
Posted

I have FEP Blue and haven't had my surgery yet but this possibility makes me hopeful! I don't know how bad the skin issues will be and I have already been trying to think up a plan to round up funding so any coverage would be awesome

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Go To Topic Listing Plastic & Reconstructive Surgery

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    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
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      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
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    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
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      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
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    • BeanitoDiego

      BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
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    • ChunkCat

      ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
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      · 0 replies
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    • BeanitoDiego

      BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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