BCBS Federal and Plastics (Panniculectomy)

[ahillig 136]

Hey all!

Been off of here for a while but I'm successfully maintaining so I went for a plastics consult. He is recommending an extended Tummy Tuck with liposuction of the flanks and muscle repair. Obviously, no insurance will cover all of that but I'm curious if anyone has had luck with BCBS Federal (Basic Option) approving that portion.

Thanks!

[SleeveToBypass2023 1,791]

On 4/19/2022 at 10:33 AM, ahillig said:

Hey all!

Been off of here for a while but I'm successfully maintaining so I went for a plastics consult. He is recommending an extended Tummy Tuck with liposuction of the flanks and muscle repair. Obviously, no insurance will cover all of that but I'm curious if anyone has had luck with BCBS Federal (Basic Option) approving that portion.

Thanks!

I haver BCBS of Illinois (not sure if they work the same, but my surgeon's office said they take all the BCBS and they all are basically the same depending on the plan the patient chose) and i reached out to my insurance about this and they said they do not cover anything that would fall under cosmetic procedures (no Tummy Tuck, no Lipo, no tightening of the muscle walls, no body lifts, no nose jobs, nothing) but they WILL cover a panniculectomy but only if it's been deemed medically necessary and if weight has been stable for a minimum of 6-8 months. A panniculectomy is a surgical procedure to remove the pannus — excess skin and tissue from the lower abdomen. This excess skin is sometimes referred to as an “apron.” Unlike a tummy tuck, the panniculectomy does NOT tighten the abdominal muscles for a more cosmetic appearance, disqualifying it as a cosmetic procedure. However, removing the excess fat can make your abdominal area flatter, but not tighter (a tummy tuck would be needed for that).

[Blue Crystal 18]

That's super helpful! I also have BCBS of Illinois and had assumed they wouldn't cover anything. I'm starting to consider skin removal surgeries - my "apron" is pretty flabby and big. Based on this I'll call them to see how I might going about them possibly covering this. Thank you!