Plastic surgery

theshumgirl
on 6/30/08 8:43 am - Sahuarita, AZ
Hello everyone. I have not been on OH in a while and haven't ever posted but thought maybe I would try it out. I am about 15 months out from my RNY and I am really interested in getting a tummy tuck. I also have 4 children under age 9. I had to have 3 c-sections...I feel like I am never going to get my stomach back because they have cut those muscles so many times...anyway just wondering if anyone knows if this might be covered under insurance or parts of it...and if you know a really great doc you can suggest. Thanks a ton Jodell
Christmasgirl
on 7/3/08 10:07 am - ID
I asked that same question myself on the Plastic Surgery forum. Here is one of the responses I got: "Vivian is correct...they will pay for a panniculectomy but most will NOT pay for a TT...you usually have to pay the difference for that yourself. I got my insurance to pay for my panni...however I lost 274 lbs. But...you would think that I had skin hanging to my knees...but I did not!!! It hung down to the top of my pubic mound...that is it. Go figure! But they still paid. I started documenting every rash I had. Every time I got one I went to the doctor and got a script and made sure I filled it. Then I went to several surgeons, had them all write letters of necessity. Got one from my PCP, one from my former PCP and one from my dermatologist. Submitted it and they approved the panni! Now I had to fight for my other surgeries...but I am getting them to cover those as well... Insurance companies have slightly different definitions of "medically necessary" however most do not deviate far from the definition that the federal government uses and that is: services that are necessary for the diagnosis or treatment of disease, illness or injury and without which the patient can be expected to suffer prolonged, increased or new morbidity, impairment of function, dysfunction of a body organ or part, or significant pain and discomfort." I WANT ONE TOO!!!!
jjones2007
on 9/29/08 4:22 am - pearland, TX
Hi,

I had my RNY on 03/27/07 and I lost about 113 pounds I weighed 253 when I began. On 12/28/07, I had a tummy tuck. My insurance company covered both surgeries. I do not hae any loose skin other than the tummy and now it is gone. I was truly blessed. I had previous surgeries and I had that flap and I had a excellent surgeon and his insurance team knew just what to do to get me appoved. I know I probably shoud have waited but, I had alreadymet my out of pocket ad detuctible so why not? I went from aize 20 to 6-8 about. I feel great about myself. I will post some before and afters.         
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