Plastics

May 29, 2010

How funny that we're all at this stag at similiar times.  I ran the gamit (sp) trying to get insurance to cover it, even with a hernia being worsened by the skin and still insurance wouldn't cover.  Now this is Anthem in VA so I don't know about the others. The good news is they will cover the hernia surgery and I got my docs to work together so I only will have to pay for the Plastic surgeons part. Which is 4 grand,.  Mind you that is a whole lot in my world but to finally get rid of the pain of the hernia (Basketball sized and the skin issues, well lets just say It's money well spent)

Originally when I first applied about 2 years ago for the skin removal I was denied because of not having a documented ongoing rash for over 3 months, or documented back pain from itl. Mind you I had all these things just not documented to their satisfaction.  Grrrrr.  Worked out for the best though because this way they covered the RNY and I couldn't be happier with the weight loss.  Though I still laugh,  They won't  cover the 5000 dollar surgery, but they'll cover the 30,000 one.  Don't figure???? 

This time when I applied I had all the back documentation, rash documentation, they did the pictures of the sagging skin etc.   You know the ones that make you feel sooo lovely.  And I was rejected for several reasons.  One was not being 18 months out yet, which at least was understandable, but the other two are this.  Your BMI has to be under 30 and stable for at least 6 months before they'll even consider it.  And you and I both know by the time that's done they will have more regulations to deny me.,  Therefore I opted to get rid of the pain, etc.  3 years of pain due to an abdominal hernia, left over from weak skin areas where I had  to have a colostomy, that has continued to grow and hurt worse is enough.  Truthfully I feel really screwed over by insurance, but they have us where they want us.  

They were always ready to fix the hernia, but my doctor and I both knew it would never hold given the pull in that area and well because they wasn't a medical journal to back it up here  I am.

Sorry to rant and rave, BUT TO THE GOOD NEWS!  i GO IN FOR SURGERY ON JUNE 2.  Hernia repair and excess skin removal , A few weeks of healing and tada a much happier pain free Lori :0)

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