Personal Choice Blue Cross/Sheild Pays for Reconstructive After WLS ...WHAT??????
Thanks a bunch,
on 6/30/10 10:55 am
Good luck to you!!!
None. Zero. Zilch. Nada.
Pain factor? You can't even imagine. Seriously.
"Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert Lap RNY 7/07-- Lap Gallbladder 5/08--
Emergency Bowel Repair 6/08 -Dr. Meilahn, Temple U. Upper and Lower Bleph/Lower Face Lift
Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09 -Dr. Pontell, Media PA Mastopexy/Massive
Brachioplasty/ Extended Abdominoplasty (plus Mons Lift and Upper Leg lift) / Hernia Repair
6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10 - Dr. Ivor Kaplan VA Beach
Total Cost: $33,500 Start wt: 368 RNY wt: 300 Goal wt: 150 Current wt: 148.2 BMI: 24.7
Contact your HR rep for a copy of your policy if you don't have one.
As for pain, that depends on the pain tolerance of the individual. For me the LBL wasn't as difficult as the thighs. For others, it's the opposite.
Hey, Kathy, let me know how it goes. I'm a Barix baby too. I did go to a plastic surgery consult with Dr. Lam. He believed that my arms would not be covered, and there were specific requirements for the tummy tuck in my Personal Choice policy. I believe it was 6 months of documented rashes, or something similar.
WLS 5/31/07. Maintaining a weight loss of 141 pounds and feeling amazing!
Hi Kathy, it’s not so much what insurance you have, but what your specific plan covers, regardless of the company, there is a wide range of coverage plans out there, even within the same company. If you have insurance through your employer and it is “self-funded”, meaning the insurance company “manages” the plan for your employer, your employer can design just about any plan they want. My advice is to request the official plan coverage for your plan, they usually have it on line, and read the fine print; there are often loopholes that can be explored. If a plan covers weight loss surgery for health reasons, very often they will also cover “reconstructive surgery”, there is no plan out there that will cover cosmetic surgery, a play on words, I know. The plastic surgeon you choose needs to clearly document all the issues supported by your PCP’s documentation, it’s also important that he has experience dealing with weight loss patients and the submission of such claims; we are a different “animal” as they say.
There is still a chance, as I see here by some posters that it won’t be covered, but here is what happened to me. My doctor submitted for a Breast reduction, not a Breast Lift, they must remove at least 400 grams, my surgeon only ended up removing 200 grams, somehow my insurance covered it upon submission. My surgeon submitted a panniculectomy, not a tummy tuck, the latter tightens the stomach muscles, the first does not, again, I agreed to pay the difference, but my insurance ended up paying for it upon submission and I ended up with a credit after paying. I also had a few procedures together, so the hospital and anesthesia would be covered, the only potential for non-payment, was the Tummy Tuck, but in the end it was all covered. I also had my top lids done (dropping skin/visual impairment) I was referred to have a vision test and it was also covered. Do your homework and check the Plastics Forum, Good Luck!