Question:
No rashes or health problems.How do I get insurance to pay for plastic surgery?

Hi everyone! I am 13 weeks out from WLS...open RNY. Have lost 55lbs, and I know SOMEDAY in the near future I will want to have a tummy tuck & breast lift. How can I get the insurance company to pay for it, if their criteria is "medically necessary"? I've never had (and still don't have) any problems with rashes or anything like that associated with my breasts or lower stomach. I am very tall (5'11") and my stomach has never "hung" like I read about. My weight has always been very evenly distributed. But don't get me wrong, I do have a "pouch" (hey, now I have two!! LOL) & my boobs DO hang!!!! LOTS!!! I HATE THAT!!! So....if there are no medical problems associated with these "problem areas", how can I deem this "medically necessary" for the insurance company? Any thoughts or ideas?.....bring 'em on!! Thanks a bunch guys! ***GretcheeGirl***    — blank first name B. (posted on May 30, 2002)

May 30, 2002
I hate to be the bearer of bad news but if it is not a medical necesicty they may not have to cover this surgery. If you lie and say you have a rash you will be committing fraud. Maybe you will have to pay for this yourself.--- Good Luck
   — Robert L.

May 30, 2002
Robert, if I had intended on lying, then I wouldn't have had to ask this question, now would I? I would like to know an honest, ethical way. I think I remember just reading something about insurance paying for plastic surgery because it's considered reconstructive...anyone have any more info on that? ***GretcheeGirl***
   — blank first name B.

May 30, 2002
I hate to say it, but I think it's unlkely that you'll get something "deemed medically necessary" if you readily admit that you don't have any medical problems from it. Might as well give it a shot and run it by your insurance company, but you may want to start figuring out how to save up some money or researching financing for self-pay. That's my plan. Good Luck!
   — PaulaM

May 30, 2002
Read my profile...unfortunately, all I have been successful with in the way of coverage was the abdominoplasty. Even though I have rashes and other problems associated with excess skin, my insurer contradicts what my surgeon says. It's been a nightmare. I've retained an attorney, but have lost faith in her. I'd rather spend my $$ on the surgery than risk not winning a lawsuit. At least I'd walk away with what I went after. That may sound selfish, but it's how I feel. I got a final price on all the procedures from my surgeon today. After picking myself up off the floor, my boyfriend and I are going to figure out how to pay for it tonight. Whatever it takes, I'm going for it. It's my life, my body, and I deserve it!
   — [Deactivated Member]

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