Will insurance ever cover a lower body lift?

songbird177
on 5/8/14 4:20 am - Carmichael, CA
DS on 12/03/12

I live in California and was told by a plastic surgeon a lower body lift would be the best option for me after losing 180lbs. I am just wondering if there is any chance of getting insurance to pay for this? My current plan covers a panni with proper documentation but I need more than just a panni. I have the works: chronic yeast infections, pain, rash, etc. I have Anthem at the moment but have the option to switch to Kaiser, Blue Shield, or one called Western Health Advantage. Thanks in advance.

Cicerogirl, The PhD
Version

on 5/8/14 4:46 am - OH

I have never heard of insurance covering it since the excess skin outside of the panni area doesn't cause any medical issues and is therefore considered cosmetic.

I am sure that everyone who lost as much weight as we have (I lost 190) would look best with a full LBL, and every surgeon in the world will encourage you to do that to get the very best results (and help pad the surgeon's checking account), but it IS cosmetic only and most people "make due" with just the panni or a tummy tuck.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

ChristineB
on 5/8/14 11:40 am - Western 'Burbs Chgo, IL
On May 8, 2014 at 11:46 AM Pacific Time, ****rogirl, The PhD Version wrote:

I have never heard of insurance covering it since the excess skin outside of the panni area doesn't cause any medical issues and is therefore considered cosmetic.

I am sure that everyone who lost as much weight as we have (I lost 190) would look best with a full LBL, and every surgeon in the world will encourage you to do that to get the very best results (and help pad the surgeon's checking account), but it IS cosmetic only and most people "make due" with just the panni or a tummy tuck.

Lora

My husband's insurance paid for his panni as they determined it was medically necessary (had to be over 100#). He had lost close to 150# at that point. He was covered by Aetna POS at the time. Every insurance has their criteria.

 

 
Open RNY May 7
260/155/140 




 

Citizen Kim
on 5/8/14 12:01 pm, edited 5/8/14 12:01 pm - Castle Rock, CO
On May 8, 2014 at 6:40 PM Pacific Time, ChristineB wrote: On May 8, 2014 at 11:46 AM Pacific Time, ****rogirl, The PhD Version wrote:

Deleted and reposted because of editing to a quoted post

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

Citizen Kim
on 5/8/14 12:04 pm - Castle Rock, CO
On May 8, 2014 at 6:40 PM Pacific Time, ChristineB wrote:
On May 8, 2014 at 11:46 AM Pacific Time, ****rogirl, The PhD Version wrote:

I have never heard of insurance covering it since the excess skin outside of the panni area doesn't cause any medical issues and is therefore considered cosmetic.

I am sure that everyone who lost as much weight as we have (I lost 190) would look best with a full LBL, and every surgeon in the world will encourage you to do that to get the very best results (and help pad the surgeon's checking account), but it IS cosmetic only and most people "make due" with just the panni or a tummy tuck.

Lora

My husband's insurance paid for his panni as they determined it was medically necessary (had to be over 100#). He had lost close to 150# at that point. He was covered by Aetna POS at the time. Every insurance has their criteria.

 

I think you misunderstood Lora's post - she was saying that anything MORE than a panni removal is unlikely to be covered ...

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

Cicerogirl, The PhD
Version

on 5/8/14 12:15 pm - OH

As Kim said, the OP asked about insurance covering a lower body lift, and my response was that insurance doesn't cover that because nothing beyond a panniculectomy is medically necessary.

MANY insurance policies cover a panniculectomy when there is a certain amount of excess skin and skin issues.

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Eggface
on 5/8/14 12:32 pm - Sunny Southern, CA

I have heard of patients getting a procedure covered by insurance and then self paying for additional surgical procedures during that procedure. It wasn't TT to an LBL (It was TT approval and while under they did self pay BL, cut the costs for self payer as it was same anesthesia, hospital/surgeon fees, medications) but I suppose you could ask your plastic surgeon if that can happen. 

 

~Michelle "Shelly"

Weight Loss Surgery Friendly Recipes & Rambling
www.theworldaccordingtoeggface.com

huskergalWsD
on 5/8/14 1:05 pm

this may not answer your question, just thought I would tell you what I read a few times on OH . Don't know how legal it is, but some women that had a hernia repair also got plastic surgery under the same procedure, cost covered from the insurance company

                              
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Cicerogirl, The PhD
Version

on 5/8/14 11:02 pm - OH

A hernia repair would involve the abdominal muscles, which is why that can sometimes be combined with a tummy tuck, but a LBL is a completely different animal.  Not only does it take a lot of additional OR time, etc., but the incisions aren't even in the same area.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

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