Question:
Anybody with BC/BS Federal and plastic surgery. Please Help
I am one year out from LAP RNY. Ihave lost 116 pounds. Thinking of TT, Breast, Arms , Legs , Chin. If you have BC/BS Federal and they paid for any thing. Would you please share you story? What did you use for medically nessesary reasons? Did you have to have documentation of anything? Any answers will be helpful!!! — Gail R. (posted on August 10, 2002)
August 11, 2002
A good place to get information like this is from the post-op
plastic-surgery Yahoo group
(http://groups.yahoo.com/group/ossg-plasticsurgery). Good luck.
— Kay B.
August 11, 2002
I don't have an answe for you, but I read your profile and wanted to write
you. I to have Federal BC/BS. Since I had my open RNY this year (3/06) I
did have to be precertified and have to pay some out of pocket. I was
approved on the first try and my share of the $48,000 bill has only been
about $1100. So while it wasn't cheap I am so grateful for the insurance.
I started at 337 1/2 lbs. and after 5 months I have lost 91 1/2. Since I'm
only 5'3" I have quite a ways to go. I had a check-up with my surgeon
on 7/25 and he agreed I definitely will need the abdominoplasty. I also
need my arms and thighs done and a breast lift. I too worry about the
insurance not paying. I'm a single mother and terribly in debt from
raising my 2 children and helping with grandchildren. I go tomorrow to see
my family physician for my annual check-up. I haven't seen her since
before my surgery, so that will be fun. I've read about criteria for
getting insurance to pay for the reconstructive surgery, and I've made a
list of complaints to cover tomorrow, so we can start the documentation
process. I know I can't have the surgery until I get down to about 150--my
surgeon told me I would probably lose 20 lbs having the reconstructive
sugery. He also wants me to lose as fast as I can. Told me to keep the
calories down in the 700 range. Isn't it funny I feel like I'm cheating if
I eat 100 calories. I really really want to be down to 150 at my surgery
anniversary date in March, but I know that might not pan out. I am also
starting to find out more about plastic surgeons in my area. I had to
drive 2 hours to get the RNY done and know I will have to go out of town
for the reconstructive surgery. I want to be prepared for the insurance
struggle and knowing who I want to do it when the time comes. Let me know
how you turn out with the insurance, since you will be going through it
first. I have wondered if some of the other federal insurance plans would
work better for this. When it gets closer to open season, I might check
that out.
— jan M.
August 11, 2002
BC/BS Federal paid for my extended Abdominoplasty (including Panni)...I
didn't have to prove anything. My Plastic Surgeon just took one look at me,
said "oh yeah - THAT definitely affects the quality of your
life", took pictures of me naked, wrote a letter of medical necessity
to BC/BS and three weeks later I had surgery.
— Cathy J.
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