Plastic Surgery Question

[aayers88 31]

So as of Feb 2014 it will be my 1 yr anniversary of my gastric bypass... I do have the skin folds on my stomach area but idt they will meet what is needed for the instance company to pay for a tummy tuck... I was wondering what is the soonest anyone has had plastic surgery after their bypass with no insurance approval. If I was getting it covered by my insurance I would have to wait 18 months, but I don't see that happening. Should I still wait the 18 months. I have about 40 more pounds to lose and I want to lose it before my year anniversary...

[Shannon Mcmanus 32]

I would make an appt to see the Plastic Surgeon and see what they think....

[CaliGal 35]

My surgeon said to wait two years. At that point your weight should have stabilized.

[pear425 32]

If you still have weight to lose it wouldn't make sense to have surgery yet. Do you have rashes and skin problems in your belly area? Have you been documenting the problem with you doctor? I know these are all things insurance look at. My surgeon is clear that if we need/want plastic surgery you should weight 18-24 months.

[aayers88 31]

I have about 40 pounds left... I want to get down to my goal by February and maybe have it done in September or October. I do have rashes and have gone to the dr for documentation. I looked at my medical policy and it said you have to have rashes and the fold has to be below a certain point...since working out idt it's below that certain point. I probably won't be covered.

HW 332; CW 225; SD 02/28/2013; GW 175

[aayers88 31]

The one thing I'm worrying about is I have Highmark BCBS as my insurance and my drs are through UPMC - at the end of 2014 Highmark won't be accepted at UPMC so I would like to get it done before December of next year...so many things ughhh

HW 332; CW 225; SD 02/28/2013; GW 175

[krissydeem 52]

I didn't have a Tummy Tuck yet but I had the skin removed from under my arms and a breast augmentation and I am 18 month out and at goal for over a year. Most doc suggest waiting 2 years.

[missysue 127]

The one thing I'm worrying about is I have Highmark BCBS as my insurance and my drs are through UPMC - at the end of 2014 Highmark won't be accepted at UPMC so I would like to get it done before December of next year...so many things ughhh HW 332; CW 225; SD 02/28/2013; GW 175

I also am having the same issue as you! I love my Dr. out of UPMC but I also have Highmark insurance. It sucks we are gonna have to change doctors:(

[Angela Quddus 0]

^{I am 2 years out from surgery...I have lost 211lbs and I am within 30lbs of my ideal body weight. I am currently on Medicare and permanent disability. Does anyone know if it is possible to have skin removal surgery while on Medicare? I do not care so much about it for cosmetic reasons, I would just like to be free of the constant rashes and raw spots as well as these horrible backaches.}

[countrygirl 84]

^{I am 2 years out from surgery...I have lost 211lbs and I am within 30lbs of my ideal body weight. I am currently on Medicare and permanent disability. Does anyone know if it is possible to have skin removal surgery while on Medicare? I do not care so much about it for cosmetic reasons, I would just like to be free of the constant rashes and raw spots as well as these horrible backaches.}

I believe rashes & irritation is exactly what drs need to submit for skin removal approval.

[mamafine23 101]

Hi, yeah I highly recommend documenting everything ... Take pictures of skin issues that you come across because you have to basically prove medical issues resulting from the extra skin ... I am in the same situation and I work for bcbs....the upmc thing is not going to last... The pa dept of ins will stop upmc from denying care due to Highmark being the medical insurer ... Right now it's based on a product which is the community blue , it has lower reimbursement so they don't want to accept it...but it's a lot higher reimbursement than Medicaid ... Hospitals shouldn't be a hospital and medical insurer...