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Tummy Tuck - Insurance Covering

melindam2
on 4/2/08 1:43 pm - Campbell, CA
Lap Band on 07/06/06 with
Hi, has anyone ever heard of an insurance company paying for a tummy tuck because of recurrent yeast infections under the stomach area?  Insurance did not pay for the original weight loss surgery. Thanks!
LITTLE_OLD_ME
on 4/2/08 2:25 pm - FRANKLIN, MA
Hi.  My insurance paid for mine.  Actually they paid for the Panniculectomy portion which is only removing the skin.  For the full TT where they tighten the muscles too, you may need to pay that portion.  It wouldn't hurt to submit it to your insurance.
Vickie W.
on 4/2/08 3:17 pm - Murrieta, CA
Good Luck, Make sure you have lots of documentation.  I had lots of pictures over several months and a doctors letter, but not dermotoligist and chiro.  I was always told to treat with over the counter meds and did not have prescriptions.  So they claimed not enought documentation, and not medically necessary. My insurance only covered the hernia portion of my entire surgery and they denied the rest.   But, the surgery center submitted a claim 7 months after my 11/27/06 surgery for $25,000.00 for hernia repair and Aetna paid $24,000.00 of that. My self pay quote for the entire surgery was, and I financed, $24,000.00,  for LBL w/ muscle repair and thigh lift, which was paid 1 month prior to my November 2006 surgery.   The surgery center had me pay them upfront before my surgery (11/27/06) $360.00 which they said was my 10 % co pay for hernia portion of my entire surgery.   The surgery center portion of my self pay quote was approx.  6900.00.

Vickie      (5'3"-Starting Wt-275  /  now-165 /  (My Goal 150)
12/10/03 - RNY Gastric Bypass - Dr. Francis Essien
11/27/06 - LBL, Medial Thigh Lift, Muscle and Hernia Repair - Dr. Katzen
 7/9/08-BL/BA/Upper Torsoplasty/Brachiaplasty/outer thigh lipo-Dr. Katzen
www.bodybykatzen.com  
This helped me Heal Fast ** 
www.thegreatproduct.com/vickiew  

 
 

katwig
on 4/2/08 4:00 pm
Hi Vickie, I, too, am looking into TT and have a hernia as well... I'm not sure that I followed you... Your entire TT and hernia repair cost was $25,000 and Aetna paid $24,000 for just the hernia repair?  So did the entire TT/hernia/thigh lift/LBL end up costing you $1000 out of pocket?  My PS is submitting the insurance request and my chiro and primary care are faxing letters about recurrent infections, etc.  I have also used mostly over the counter meds.  Chiro can document herniated discs in lower back, etc., so maybe that will have some influence, who knows.  I guess the worse they can do is say "no", and I'm no worse off then I am already.  I intend to pay for breast lift with aug out of pocket -- after 160 pound weight loss,  I am not a pretty sight  lol.   It's hard to find a ps who even will submit the claim-- I guess they end up not getting paid enough when insurance is paying and they would rather have self pay. Thanks for any info you can provide!   I have Anthem Blue Preferred Primary (BC/BS), I was already denied in the past by UHC but this is a new insurance so we shall see. Thanks! Kathy
Vickie W.
on 4/2/08 4:15 pm - Murrieta, CA
Nope, Aetna paid the surgery center 24000. for what they submitted was hernia repair surgery. And I financed everything for 24,000.00.  I called the surgery center foolishly thinking that they would refund me the 6800.00 that they got from my finance company for my self pay since they got so much from my insurance, and they said no refund that was the charge for hernia repair surgery and that they are allowed to overcharge the insurance company.

Vickie      (5'3"-Starting Wt-275  /  now-165 /  (My Goal 150)
12/10/03 - RNY Gastric Bypass - Dr. Francis Essien
11/27/06 - LBL, Medial Thigh Lift, Muscle and Hernia Repair - Dr. Katzen
 7/9/08-BL/BA/Upper Torsoplasty/Brachiaplasty/outer thigh lipo-Dr. Katzen
www.bodybykatzen.com  
This helped me Heal Fast ** 
www.thegreatproduct.com/vickiew  

 
 

Vickie W.
on 4/2/08 4:36 pm - Murrieta, CA
I went into it self pay so, and it is worth it,  the refund would have helped with my pending surgery, but maybe my insurance will pay for all or part of my upcoming, hopefully.    Keeping my fingers crossed!

Vickie      (5'3"-Starting Wt-275  /  now-165 /  (My Goal 150)
12/10/03 - RNY Gastric Bypass - Dr. Francis Essien
11/27/06 - LBL, Medial Thigh Lift, Muscle and Hernia Repair - Dr. Katzen
 7/9/08-BL/BA/Upper Torsoplasty/Brachiaplasty/outer thigh lipo-Dr. Katzen
www.bodybykatzen.com  
This helped me Heal Fast ** 
www.thegreatproduct.com/vickiew  

 
 

beaglecookie
on 4/7/08 11:36 am - Whittier, CA
My insurance is blue shield/ Blue Cross of Illinois, but my employeer will be changing to Athem Blue Cross in July. The paper work was just submitted about 3 weeks ago. I have a LBL scheduled for June 5th if approvals go through, but will have to resubmit to Athem after July for the Breast lift. Let us know if you get approved through Athem and what info their asking for. Thanks

 

 

 

  
maureen L.
on 7/7/08 7:47 pm - Pasadena, CA
Hi, Congratulations on everything! I read your profile....I want to hear more....about the recovery and trhe result. I have a LBL and medial thigh scheduled with Katzen for the end of July. They submitted to Anthem Blue cross PPO...I useed to ahve BC CA PPO.... I am doing Care CArd to finance what they won't pay...I cannot take my retirement out because it is a GRA.....so I have to d this. Did they end up paying for any part of your plastic/reconstructive surgeries? I am really anxous to hear how you are doing and about the insurance. You can post her or write me a pm Thank you so much....and I hope all is very well with you. Maureen