How can i get my insurance to pay for my skin remove surgery

Hockeymom87
on 9/11/21 2:23 pm
DS on 03/17/19

My insurance will not pay for my excess skin that hang down to my knees it hard for me to walk i used weigh 650lbs

Partlypollyanna
on 9/11/21 5:18 pm
RNY on 02/14/18

Work with your doctor to document the medical need. Insurance will consider it cosmetic unless there is a medical record otherwise

HW: 306 SW: 282 GW: 145 (reached 2/6/19) CW:150

Jen

White Dove
on 9/12/21 9:04 am - Warren, OH

Consult a plastic surgeon. Ask your weight loss surgery office to recommend one who works with people with massive weight loss.

Find out the cost and the figure out a plan to pay for the surgery. People might borrow from their retirement plan, get a second mortgage, get a second job, borrow from a family member, or get a loan.

The plastic surgeon's office can give you options. They may be able to get your insurance to cover some or even all of the cost. When I had plastic surgery, I decided that my body was as important as a car.

I make a big loan for a car and pay it off. I was willing to spend what it took to remove the excess skin and feel better about my body.

Real life begins where your comfort zone ends

Member Services
on 9/15/21 1:30 pm - Irvine, CA

There are a few Plastic Surgeons who will work for you to submit documentation as well as the letter of medical necessity to assist in getting your reconstructive surgery covered by your insurance. Those surgeons are few and far between, but they do exist. A couple of things to keep in mind when you start talking to offices:

  1. Ask if they will bill your insurance or do you have to pay for your procedure upfront? Most surgeons will want you to pay for the services out of your pocket, but provide you with the necessary billing details for you to submit it to your insurance and that is as far as they go.
  2. If they will bill your insurance, ask them if they do all the documenting and preparation for submission of the LOMN.

When documenting for plastic surgery, start bringing up issues you are having with the excess skin to your PCP. Issues like rashes, any pain you have from hanging panni, impacts of the excess skin that limit your day-to-day activities (not related to cosmetic purposes) Photos of any rashes you get are very helpful. If you are having back pain and your dr. suspects it is due to your excess skin make sure he notes that. These types of documentation will support any information and LOMN that your plastic surgeon will submit.

Lastly, some insurance policies will cover reconstructive surgery due to the issues above, but will not cover for cosmetic purposes. That is the goal of the surgeon and any prior documentation/photos to show the need for removal of excess skin is necessary to lead a normal pain-free.

I hope this information is helpful.

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