Does BC/Blue Shield Ever Approve Tummy Tuck?

carolmoore2
on 6/7/11 10:22 am

Has anyone ever been approved for Abdominoplasty by Blue Cross Blue Shield. 

              
Anna M.
on 6/7/11 10:29 am - Manchester, NH
I have heard they will sometimes cover a lower body lift if there are health problems (rash, fungus, etc) caused by excess skin. I don't think they will do an actual tummy tuck because that is considered cosmetic.
    
* Starting weight: 383 * Day of Surgery: 363 * Ticker includes weight lost pre-op *
shellbell75
on 6/7/11 10:36 am
I have Anthem and have the info saved. They will cover a panni, with extensive documentation (of rashes that were unable to heal with 3 months of treatment) and pictures.
**SHELLY**   HW: 316   SW: 256   GW: 125  CW: 118       
 

 
laura_vermont
on 6/7/11 10:43 am
Yes.  My surgeon called it panniculectomy throughout my consults, but ran into a hernia repair at surgery & did the muscle work.  My insurance statements have all indicated payment for abdominoplasty.  A nice surprise! 

I just got the reports this week that it was indeed an abdominoplasty vs a panniculectomy -- I fully expected that insurance would only cover the panniculectomy and that was what was done.  Most of the time, just panniculectomy is covered. 

High Weight 278; consult weight 234; Surgery Weight 219 Surgeon's Goal Weight 150 -10/27/10  -  Personal goal weight 140 - Achieved 12/11/10  
  
carolmoore2
on 6/7/11 12:20 pm

Wow, lucky break!  I was told by one of the Cosmetic Surgeons office that they call it a panni as well and that BC never approves a tummy tuck or adbominoplasty!

OH, WELL, would have been nice!   thanks ALL! 

Krisnet
on 6/7/11 4:47 pm
I was just approved for Panni, they would not cover abdominoplasty (considered cosmetic)  I have harvard pilgrim.
Reesheda H.
on 6/8/11 12:42 pm - Jackson, MS
Is there a huge difference in panni and abdominoplasty
            
Krisnet
on 6/8/11 6:41 pm
The Panni is the lower abdomin that hangs down from excessive weightloss and can cause infections.  From what I was told it is the only procedure that might be covered by Insurance.  Abdominoplasty, I think is what they consider above the belly button and they consider it cosmetic.  My surgeon put in a request for both procedures for me, but they only approved the panni. 
Cicerogirl, The PhD
Version

on 6/8/11 6:47 pm - OH
Only rarely will any insurance over a tummy tuck unless you have a hernia that needs repaired.  They will frequently cover the panniculectomy, though, if you have rash issues.

Lora

 6 years out and maintaining 190 pounds lost!  

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