Plastic Surgery Insurance Question

I have just found out that my insurance will no longer be accepted at the hospital at which I just have my RNY. I can still receive services through my Surgeon through his personal office, but if I have to have any procedures at the hospital, I have to pay out of network costs or I have to change insurance companies.

SO my question is, what insurances have seemed to cover plastic surgery post WLS? I am more than likely going to need a panniculectomy. So, if I have to change, and I know I'm going to need this procedure, then I might as well make a choice that would most likely lead me to my end goal, right??

I'd appreciate any advice. I currently have Medicare and it's the extra Plan B and D part that is not being accepted anymore - UnitedHealthcare AARP. Oh, and open enrollment is October. 

If you have not done so already please post this on our Plastic Surgery Forum.

I tried to but didn't see any posts or a way to post.

It's kind of hard to find. You need to click on the link that says "Message Board".

Is there only one hospital in your area?? Were you planning to have your RNY surgeon do the panniculectomy rather than have a plastic surgeon do it?  I wold think that it would be easier to keep  your current insurance  (assuming it covers a panniculectomy and that you will meet the "medically necessary" criteria to be approved) and use a plastic surgeon (who has experience with poor quality post-WLS skin) and who goes to whatever hospital your insurance does cover.  

Sometimes it is difficult to find out specifically what hospitals and doctors are covered by a particular insurance plan when you are "insurance shopping", let alone find out what their specific criteria is for a particular procedure (a panniculectomy might be covered for SOME of their plans but not others, so unless you can get ahold of the group number you would be coming in under, it will be difficult to get an accurate answer).

Lora

Thanks. The deal was that the hospital that my surgery was performed at was dropping my insurance...so the only place that my surgeon operates. But they evidently worked something out, so they will still be covering me.

I hadn't heard about RNY surgeons performing the pannis, but I will definitely look into that. I just know it will need to be done, and I would hope that I could get it covered by insurance. 

Some people use their RNY surgeon, but you almost always will get better results with a  plastic surgeon with experience with WLS folks.  Our skin can be challenging to work with and most RNY surgeons just don't have the expertise.

Lora