Recent Posts
Topic: RE: HELLO TO MY NJ SISTER & BROTHERS UPDATE SINCE SURGERY ON 3/28/11
TO ALL WHO WISH TO TALK ... GIVE ME A CALL ANYTIME AFTER 3 PM UNTIL 11PM USA EASTERN STANDARD TIME AT 862 ~ 252 ~ 6516 ... I AM A OLD-FASHIONED GIRL "STILL PREFERRED" IN SOME AREAS.
Topic: RE: Plastic surgery & Blue Cross/Blue Shield
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...
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...
Topic: RE: Plastic surgery & Blue Cross/Blue Shield
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..
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
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
Topic: RE: Nutritionist and Psych consults???
Let me invite you to call my office. The max out of pocket is 175 but we participate with most ins cos. Our office is in Lincoln Park where you live.
Where ever you go....please do not view it as just a roadblock...you should get something out of the consult.
Good luck
Dr Mike
Where ever you go....please do not view it as just a roadblock...you should get something out of the consult.
Good luck
Dr Mike
Michael L. Sakowitz, Ph.D. is a psychologist (NJ 35SI00148700) and member of ObesityHelp's Mental Health Board. By posting, he makes no promises, guarantees, representations, or warranties, expressed or implied, and assumes no duty or liability with regard to the information contained herein. This post is not intended to diagnose or treat any physical or mental condition. No professional services are being rendered and nothing is intended to provide such services or advice of any kind. No website or informational post can take the place of seeking professional help. If you need professional help of any kind, please seek the services of a professional or dial 911.
Topic: RE: Nutritionist and Psych consults???
I went to the nutrionist thru my surgeon and since she was part of the group it was covered. My dr. Is about an hour away from me and I didn't want to go all the way up there just for a psych eval. So I called around to local bariatric surgeons and thet gave me options, I ended up going to Carmencita lanez around woodbridge. She was covered by my ins but if it didn't it was like 120. She was pretty fast and seemed to do it alot. I would give her a call
Topic: Plastic surgery & Blue Cross/Blue Shield
Has anyone been able to get approved for plastic surgery after weight loss surgery with Blue Cross Blue Shield?
Topic: RE: Support Groups are a MUST
I am in 100% agreement - PARTICIPATE IN A SUPPORT GROUP!!! It is a fact that those who attend supports groups have increased weight loss long term!!!!!!!!!!!!!!
And Joianne, I love to see that you also talking about GAINS!! While we obsess over the loss, it’s the GAINS that’s really important. And you listed so many!!
Thanks for sharing!!
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
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
Topic: RE: Dr. Oz Show
I didn't see this, but I am recording the replay.
And Maryellen you always humble me
. Thanks for the kind words
And Maryellen you always humble me


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
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