Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Coventry Summit denied Brachioplasty



Recommended Posts

Yesterday I received notice that my Coventry Summit Medicare Advantage plan has denied the removal of the excess skin from my arms. I have lost over 280 pounds, have had infections in the fold area of the elbow, have CTS, Ulnar Nerve damage and a left frozen shoulder and must wear shirts larger than my body to accommodate the size of these arms. My Doctors and I are going to fight this and hope for the best. Others whom were approved what did you do that got the insurance company to say yes to this much needed surgery?

arms.jpg

Share this post


Link to post
Share on other sites

I'm so sorry you were denied and so glad you and the docs are going to fight it! You deserve it and the extra skin is a health risk!! ((hugs))

Share this post


Link to post
Share on other sites

Does your policy spell out what is required for it to be covered? Or is it a specific exclusion?

Many policies exclude certain plastics no matter the condition. Others (like mine) spell out specifics... for example a number of inches or a number of grams and no matter any other complications if you don't meet the specifics won't cover it.

Getting a copy of your plan and its requirements will help you address them and hopefully get approved. I didn't meet my insurances specifics. So no matter the rashes/infections/mobility issues/clothing issues mine would not cover it. I paid out of pocket.


Share this post


Link to post
Share on other sites

3 hours ago, ssflbelle said:

Others whom were approved what did you do that got the insurance company to say yes to this much needed surgery?

I have read (in threads on this website) that it is very important for the referring doctor or surgeon TO WORD THE REFERRAL OR INSURANCE CLAIM APPROPRIATELY.

You might need expert help from a doctor/surgeon who has succeeded in making a case.

Mind you, the picture you supplied is very convincing evidence.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • 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!
      · 0 replies
      1. This update has no replies.
    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
      · 0 replies
      1. This update has no replies.
    • jparadigm

      Happy Wednesday!
       
      I hope everyone is having a lovely week so far! 
      It's been a bit of a struggle this last week...I'm hungry ALL the time.
      · 1 reply
      1. BlondePatriotInCDA

        Have a great Wednesday too! Sorry you're hungry all the time, I'm pretty much the same..and I'm sick of eating the same food all the time.

    • ChunkCat

      Well, tomorrow I go in for an impromptu hiatal hernia repair after ending up in the ER over the weekend because I couldn't get food down and water was moving at a trickle... I've been having these symptoms on and off for a few weeks but Sunday was the worst by far and came with chest pain and trouble breathing. The ER PA thinks it is just esophagitis and that the surgeon and radiologist are wrong. But the bariatric surgeon swears it is a hernia, possibly a sliding one based on my symptoms. So he fit me into his schedule this week to repair it! I hope he's right and this sorts it out. He's going to do a scope afterwards to be sure there is nothing wrong with the esophagus. Here's hoping it all goes well!!
      · 3 replies
      1. AmberFL

        omgsh!! Hope all goes well!! Keeping you in my thoughts!

      2. gracesmommy2

        Hope you’re doing well!

      3. NickelChip

        I hope it goes well! Sending positive thoughts for a speedy recovery!

    • jparadigm

      Hello lovlies!
      Today is a beautiful day in west Michigan! I hope you all have a beautiful Tuesday and rest of your week!! 🤗
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×