Plastic surgery & Blue Cross/Blue Shield

Lisa F.
on 4/5/11 10:01 am - Bayville, NJ
RNY on 07/14/06 with
Has anyone been able to get approved for plastic surgery after weight loss surgery with Blue Cross Blue Shield?
Tom C.
on 4/6/11 1:01 am - Mount Arlington, NJ
Lisa, I haven't looked into plastic surgery (....yet....), but what I do know is that even if a particular insurance company does pay, the plan you have may not allow it. There are sooooooo many variables concerning payment.

What I suggest is call to the Doctor and speak to their staff. They should know the ins & outs of what will and won't be covered.

Additionally, it's very rare that an insurance company will cover 100%, let alone some portion - unless your documentation is detailed. There are some issues that necessitates the need for p.s..
Good Luck on your Journey !!

Tom

“Nothing I will ever eat will give me the feeling I get as when I lose weight”  The views expressed are based on my own experiences - and should NOT BE FOLLOWED IN LIEU OF DOCTOR’S ADVICE/INSTRUCTIONS. Only your Doctor knows your condition, and make sure you talk to them before making any changes to your diet
checkitout
on 4/6/11 11:59 am - Newton, NJ
Hello Lisa,

I did not have BCBS when my plastic surgery was done but I will say that everything is plan specific. You have to read your specific plan and work with your surgeon to seek approval. For example, when I started looking at plastics I had BCBS and the plan I had said that it covered skin removal if it was medically necessary then I changed companies I worked for and the new company's plan said that skin removal was not covered "regardless of need" so when my husband got a new job I read every plan available before I selected the plan I picked and the Oxford plan I selected covered a portion of my surgery. I ended up having a lower body lift and had to pay about half of the surgeon's fee but none of the hospital fee.
The approval process is pretty intense, they take pictures and need documentation as to the reasons why you should have the skin removed. Make sure you have documentation..

Good luck,

Stella

PS. about the only thing insurance covers fully is a pannius removal so plan on some out of pocket...

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