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Loose Skin, Plastic Surgery and Insurance Probably Won't Pay

I know I'm probably going to be preaching to the choir but here goes.



I know I'm on my way to a much healthier life filled with compliments and praises from people who see the difference. I so happy that I made the decision to have my surgery and dealing with the skin issues afterward is something I'll address after I reach my goal. What most people don't see or even know is that we even have the loose skin or the jiggle of the fat that still needs to be lost. Exercise helps with muscle tone and strength, but fat will only break down so fast, and not overnight. It's ok by me because I know that in the end I'll not only look better/different, but will be healthier than I've been in nearly 20 yrs.



I think so many of us could be left with yet another issue to contend with because of all the extra skin, and how it can have a huge impact on how we view ourselves even after the dramatic accomplishment. Don't get me wrong I'm thrilled beyond belief to have had the opportunity to have my surgery, and that so many strides have been made in the area of obesity in general.



Here's my issue..... Insurance companies have finally gotten to a point where they'll pay for the WLS but still lag behind in agreeing to cover the surgery needed to complete the process of our transformations. Right now plastics is only covered if it can be proven that there's a "medical" reason for having it such as infection or pain. At least this is the way I understand it to be. I wonder about how many WLS patients have just as much emotional pain as they did before surgery because of the residual skin and the inability to get past how it may affect their lives. If the goal is to promote good health in general, where does mental and emotional health come into play? Surely the majority of patients that look into having plastics done aren't doing it because of vanity!!! With the extra skin clothes may not fit the way the patient envisioned they would, or it has an impact on their intimate life, or they continue to have self esteem issues. With all that being said I've been wondering if and when the insurance companies will come around and finally help with the cost of the procedures that WLS patients may need after they reach their weight loss goals.



I remember years ago when having varicose vein surgery was considered "cosmetic" and also not covered by insurance. Now just about every procedure involving spider and varicose veins is covered by most insurances either partially or completely depending on the plan. Women all over that have a tiny blue vein around an ankle or behind a knee are running to surgeons to get them fixed, and insurance pays for it.



Am I wrong to think that the WLS patient is extremely deserving of a plastic surgery procedure that may be necessary because of the dramatic results of their surgeries.


Just wondering....


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  • My insurance is paying for my tummy tuck in full I am scheduled for tummy tuck with muscle repair June 1/15 so check your insurance requirements . Good luck .

  • linedancer718
    linedancer718

    I am a kaiser member and they won't pay for it either. I feel like they are only taking us half way to our healthy new life. I'm going to do some research and write Kaiser a letter trying to convinc

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I agree totally with your above statement hopefully insurance company's start taking a closer look at this and start approving surgery to address this issue .

  • 1 month later...

My insurance is paying for my tummy tuck in full I am scheduled for tummy tuck with muscle repair June 1/15 so check your insurance requirements . Good luck .

  • Author

Who do you have your insurance with? Were there circumstances that helped get it approved, like a rash or infection?

Just curious.

  • 1 month later...

Blue care network no rash just skin iratation and skin hung over mins area .

I am a kaiser member and they won't pay for it either. I feel like they are only taking us half way to our healthy new life. I'm going to do some research and write Kaiser a letter trying to convince them to consider covering it, at least 50%, as we deserve to be emotionally healthy when it comes to our bodies as well.

It makes sense tho, I'm in the medical field & I know they only pay for procedures if they're "medically necessary" since having a tummy tuck isn't life or death insurances don't generally cover it. Keep trying though!

  • 2 weeks later...

I have United Healthcare and I asked about the tummy tuck. My insurance will cover it if I can maintain the loss for 12 months and show documented issues with skin infections and sores. I have surgery in August. One month from now. I have had 2 C sections and already have the skin infections and sores. I am hoping they will cover it when I need it.

My RNY is in August. Good lord I am gonna give up today. Every time I post I am not specific. Ugh

I have united healthcare also. Hmm food for thought. I'm pre op myself and just finishing up my sleep study. Hopefully I'll have a date soon.

It varies with everyone's insurance from what I've researched. Some have a "no way" policy, and some will pay if it is limiting your abilities/impacting your life. Obviously I hope that once I get to a comfortable weight, if I have to, my insurance will cover it -- if I need it. But if not, I will gladly pay out of pocket for it... begrudgingly.

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