Fustrated

Monday morning,  I saw the plastic surgeon about doing a panni.   The ps told me that the scheduler would call about an actual date and when to go in for pre-admittance.  Since there  papers about payment,  I asked if I could sign the papers and do the pre-admittance on the same day (the hospital is 40 minutes away).  I was told that would be no problem.  That afternoon,  his secretary told me I had to sign paper to accept responsibility if the insurance doesn't pay.  They could very well considered cosmetic.  She then proceeded to tell I could fight it but, if I lose,  I'm stuck with the bill,  Great!!!!!!!!!  I have 3 surgeons telling me that I need to have it done because of medical reason (contributing factors to my hernia, etc).    F**************** great!  Either I don't do anything and face constant hernia surgeries(I had 2 different surgeries within 8 months of each other) or, get it done and face bankruptcy. The secretary called the next day and said that she was going to attempt to put threw my secondary insurance (Medicare is primary).  She said she saw my pictures and read my history.  At that point, she told that it wasn't cosmetic but she was going to try and get an approval.  I'm so frustrated,  I''m sorry for ranting on,  it's just nobody listens at home.

 I wouldn't worry about it.  I have Medicare, too, and I had to sign the same papers for my first WLS, my panni and my revision because Medicare doesn't pre approve.  They paid for all my surgeries with no issue.  I only had lost about 120lbs and they paid for my panni.  I am sure you will have no problems.  It is just standard procedure.

So Medicare did pay for your panni? You say you'd 'only' lost 120 lbs---do they go by what per centage of your excess weight you've lost, or does it depend on how far down the skin hangs, or what? How much of your excess weight did you still have at that point, and how satisfied were you with the results? (Yes, I'm nosey tonight. *grin*)

No problem. I lost over 100% of my excess weight. I heard different things, that you needed to lose at least 100lbs or that it had to hang over to a certain point over the pelvic region. Medicare told me that it had to be deemed "medically necessary". I met all those qualifications. The surgeon told me that he wasn't worried about Medicare paying, that they always did in cases like mine and they did.
I was very satisfied with the results for what it was, removal of the skin on my lower tummy. My upper tummy is still a wreck. I didn't have a tummy tuck and I didn't have high expectations. I no longer have skin issues there and my clothes fit appropriately so it did what it was supposed to. And even when I regained 100lbs, after I lost the weight it bounced right back so I can't complain.
Not saying I couldn't use a full abdominoplasty but given my limited resources that probably will never happen so I am very glad that insurance paid for what they did.
Now if I could just convince Medicare that it was medically necessary to have perky breasts I would be happy

My skin goes down to almost mid-thigh.  From the waist up,  I like the way I look.  .I just need to work on my tan.From the waist down, I look like something out of the freak show.  Right now, I have 15 -20 lbs of excess skin.  So, I'm at or below my personal goal.  At this point,  I'm 15 lbs lower than my surgical goal.  I did this because I've heard about the dreaded the bounce back.  Besides MsBatt,  you always come with really good comments.

Yikes, that must be pure murder on your lower back :-/.

Sometimes, it can be.   I find that I have problems when I overdo it in walking or exercises. The other problems is my intestinal wall is weak and the skin causes pressure in my abdomen. (I've had 2 hernias with 8 months).

Thank you for sharing the information.  I really needed to hear that.  It helped calm me down.  If there's a way for Medicare to pay for perky breasts,  could you please let me know? LMAO