Please reply.. PS questions

DISNEYMOUSEFAN
on 3/25/10 8:53 am
Hello,
I has WLS on 11/05/2009 I know its early but I want to know all the right things to do. I have lost 75 pounds since Nov. I started at 240 and now am at 165. I am 5'3" tall. I am looking to get a TT and have been getting horrible rashes under my stomach. I have been using the Nystatin powder and documenting everything with my doctor. I have stalled alot and havnt lost alot of weight recently but have about 20 more pounds to lose.. Is there a waiing game for insurance policies as far as time or what? This is all new to me. Please give me whatever advice you can. I have Univera POS which I feel is great insurance. Please let me know anything you can say and advice you can offer. Thanks Angela
Hopeful-OH
on 3/25/10 9:19 am - Fairborn, OH
Congratulations on your weight loss.  Each insurance carrier has different requirements, but I do believe most want you to have maintained your weight loss for at least a year, at least 100 pounds lost, rashes & some want your stomach to hang to your pubic bone.  But each is different, so your best move is to call your carrier.

I also have been struggling with the rashes, the Nystatin didn't help, but the prescription cream did (can't remember the name, but it's also used for jock itch).  I'm having my panni removed on April 6th.  Can't even imagine not having that hanging skin. 

Good luck!
Jody ***
on 3/25/10 7:30 pm - Brighton, MI
RNY on 10/21/08 with

I had my TT 15 months after my WLS surgery.  I had lost 96 lbs by then.  My insurance does want you to have lost 100 lbs, but it also said "significant amount".  I didn't have the rashes, but that definitely is a plus for you.  Be sure your Dr is documenting them so they can be turned in for justification.

You want to be in maintenance mode if at all possible and have been -5/+5 lbs for at least 3-4 months.  I had hit my goal in August and lost a few more lbs since then, but had stayed pretty steady.

Call your insurance and find out what their requirements are.  Actually when I did that my insurance said they didn't pay for it, but the Drs office said they would - and they did.  All in how they bill it.

HW-218/SW-208/CW-126/ Lowest Weight-121/Goal-125 - hit 8/23/09/Height-5'3"

Regain 30 lbs from 2012 to 2016 - got back on track and lost it.  Took 8 months. 
90+/- pounds lost      
BMI - 24 or so
Starting BMI between 35 and 40ish? 
Join us on the Lightweights Board!

kathleenb
on 3/26/10 7:04 am

Congratulations on your weight loss!  I was 18 months post WLS when I had an anchor TT and brachioplasty.  Unfortunately my insurance did not cover any of the cost as they deemed it cosmetic not a medical necessity.  (I have lousy health insurance) My plastic surgeon was looking for weight maintenance of at least 6 months prior to doing the surgery. 
For the insurance companies each one is different in what they require before approving this type of surgery.  It would be a good idea to see what criteria your insurance has for approving a TT before seeing the plastic surgeon.

That being said, it was worth the money for me to have the TT and brachioplasty done.  They removed 11 pounds of loose skin and though it wasn't easy and took time to heal, I feel like a new person.

Good luck.

Kathy

Most Active
×