Tummy Tuck (panni + abdominoplasty) approved! But.....

[livvsmum 2,368]

I'm currently 19 months post op. So I heard back yesterday from the surgeon that my panniculectomy AND abdominoplasty was approved by my insurance as medically necessary and covered. The surgeon said usually they just approve the panni, but that not many approve the abdominoplasty, which is your typical Tummy Tuck. He will remove the excess skin, but also tighten everything up, fix the sides up a bit, and basically build me a new belly button. It is horizontal, so hip-to-hip, and the recovery is said to be pretty rough.

So the reason I'm only 1/2 approved and 1/2 excited is that my brachioplasty or arm lift was not approved, even though I have the medical documentation of the same issues occurring with the skin on my arms. So, they will send me a denial letter and it will have the appeal process. I will definitely appeal.

My date for my tummy tuck right now is May 8, but I may push it forward to the beginning of June for a variety of reasons including that I might hear back on my appeal by then & I would much rather have both done at the same time.

Sigh. I know I should be thrilled that I was approved for the panni and tummy tuck, but I can't deny that I'm a little bummed about the arm lift.

Anyone have any words of advice on getting appeals approved? I have never had to appeal because my sleeve surgery was approved, and now the tummy tuck, but I definitely want to appeal the arm lift. Any tips would be greatly appreciated. :-)

[JamieLogical 8,684]

Congratulations on your approval. The good news is that an arm lift is a much cheaper and less invasive procedure, so it's something you could always save up for and pursue on your own at a later date. The fact that you got approved for abdominoplasty is very impressive and you should be VERY grateful for that!

The recovery time from a full TT is very rough. The muscle repair is pretty killer in terms of pain level and movement restriction. I would definitely aim for at least a full 4 weeks off of work and you will need to have someone around to help take care of you in the early days. You will NOT be able to fend for yourself. I found it INCREDIBLY frustrating to rely so heavily on other people in those early days. I always thought of myself as lazy, but once I couldn't do anything for myself, I actually HATED it.

[livvsmum 2,368]

Thanks for the feedback. You're right I should focus on the positive and that I was approved for both. It would have been a bummer if I was just approved for the panni. Also helpful info on the recovery, so thanks! I'll have to look into how much an arm lift is out of pocket.

[jjinWA 511]

Thanks for the feedback. You're right I should focus on the positive and that I was approved for both. It would have been a bummer if I was just approved for the panni. Also helpful info on the recovery, so thanks! I'll have to look into how much an arm lift is out of pocket.

How did you approach getting your plastic surgery approved? What issues did you document, etc? What ins. do you have. I know this is something I will eventually need and figured Mexico was my only option even though my ins co did approve the sleeve without too much fuss. My ins is Fed Blue Cross Blue /Shield. I need to start building my case for future plastics.