Anyone who got Kaiser to cover the tuck or arms
Hi Jennifer,
Kaiser will pay to remove your pannus once you are 1 year post op, near normal goal weight - mine was based on body fat % NOT BMI, have a history of rashes that have been documented by going to your primary doctor. Your primary has to refer you to plastic surgery for a consult. Depending upon your area, there may be other things to go through. In my area, I had to attend a panniculectomy class. I ended asking to be referred elsewhere in the Kaiser system and chose to go to West Los Angeles, which is the big plastic surgery center for Kaiser. At WLA, you can pay more and upgrade to a tummy tuck where they will tighten muscles, etc. I know other people have said that they've had a tummy tuck else where in Kaiser, only to find that their belly button was repositioned, but no muscle repair and it is not the most aestheticlly pleasing job.
For me, Kaiser approved the panni removal and a breast lift. I paid extra to conver to a belt lipectomy lower body lift, and for auto augmentation of breasts. Kaiser will NOT put in implants on any one as fee for service. They only use implants for mastectomy reconstruction.
I had consults both with Dr. Touran and Dr. Lee at West LA. Dr. Lee is the only one doing the belt lipectomy there, and I was very pleased with his work, experience and ability to relate to me as a patient. He did my thigh lift in January as well. Plastic surgery is something that requires that you work closely with your surgeon as a team, and I think that West LA does this really well. The entire staff there is really supportive.
I've been told that they never cover arms or legs. My legs were really bad, but I had to pay those out of pocket. Once nice thing about staying within the Kaiser system is that if you have complications, they are covered by your plan. You just have to pay your copays.
HTH,
Jennie
Kaiser will pay to remove your pannus once you are 1 year post op, near normal goal weight - mine was based on body fat % NOT BMI, have a history of rashes that have been documented by going to your primary doctor. Your primary has to refer you to plastic surgery for a consult. Depending upon your area, there may be other things to go through. In my area, I had to attend a panniculectomy class. I ended asking to be referred elsewhere in the Kaiser system and chose to go to West Los Angeles, which is the big plastic surgery center for Kaiser. At WLA, you can pay more and upgrade to a tummy tuck where they will tighten muscles, etc. I know other people have said that they've had a tummy tuck else where in Kaiser, only to find that their belly button was repositioned, but no muscle repair and it is not the most aestheticlly pleasing job.
For me, Kaiser approved the panni removal and a breast lift. I paid extra to conver to a belt lipectomy lower body lift, and for auto augmentation of breasts. Kaiser will NOT put in implants on any one as fee for service. They only use implants for mastectomy reconstruction.
I had consults both with Dr. Touran and Dr. Lee at West LA. Dr. Lee is the only one doing the belt lipectomy there, and I was very pleased with his work, experience and ability to relate to me as a patient. He did my thigh lift in January as well. Plastic surgery is something that requires that you work closely with your surgeon as a team, and I think that West LA does this really well. The entire staff there is really supportive.
I've been told that they never cover arms or legs. My legs were really bad, but I had to pay those out of pocket. Once nice thing about staying within the Kaiser system is that if you have complications, they are covered by your plan. You just have to pay your copays.
HTH,
Jennie
Jennie
31 lbs lost before surgery
31 lbs lost before surgery
Hi if you don't mind my asking how much extra did you pay for the breasts and tummy? I am so excited to know that I can get something covered. I payed for my weightloss surgery. In additon, what criteria did they require as far as weight loss. I only need to lose 100 but I have a bad stomach area from a 12 lb kid via c section. Thanks again.
"People are healed by different kinds of healers and systems because the real healer is within." - George Goodheart
If you need just a tummy tuck, it is about $4500. more - that was the original quote over the phone before my first appointment. I didn't get a break down for the auto augmentation from the LBL. I paid $12,700 for the LBL and autoaugmentation - that also included 2 compression garments. I was very blessed that my parents paid for my LBL and breasts. I had to have 3 additional surgeries, and 7 more days in the hospital, with a price tag of over $100,000 that I didn't have to pay for.
I had my thighs done in January, and I paid $8,400 for that and was quoted $5500 for arms. I plan to do those in the fall. The gift from my mom and dad have allowed me to be able to do the other things from our savings.
As far as criteria, WLA really didn't have the same criteria - but I first had to get the referral from my primary who told me that I needed to be at least 12 months out and in his opinion close to my goal weight. At that time, I was about 197, 11 1/2 mos post op, and my body fat % was pretty low - like 25%. Also, you have to be fairly weight stable. They don't want to do the plastic surgery when you have more to lose. I don't believe that I've really lost more on my own. The loss I've had in the past year is do to surgical loss via the plastics. I had 20lbs removed in June, and my weight was around 170 when I had the thigh lift. I've been averaging 163 - 168 post thigh lift depending upon the swelling and fluid in my legs. I keep forgetting to ask how much was removed. The first time I asked, they didn't have a pathology report on the amount of tissue removed, other than what was lipoed off, which was about 4 1/2 lbs. I will have an in office revision to my legs to take off a bit more tissue where my legs rub together at the top of my thighs and revise some dog ears at the end of April, and I will try and remember to ask about how much was removed. At this point my body fat % is about 18%, and I've been told that I really cannot lose more weight. I would like to be in the 150 range, but I've learned that I probably just won't get there. I'm into a size 4/6 pant/skirt and a small/med blouse. Once my arms are done, along with the side boobs, I think I will be a small top all the time.
I had a 10 lb baby 23 years ago, and I know what that did to my tummy and muscles. I had a bad separation, and a small hernia that developed probably from my bypass surgery. I have very defined abs now, and while I have a bit of extra skin above my belly button, I have none below and it is tight and the muscles are very defined. I didn't want the scar down my belly in an anchor cut. Instead, when I have my arms done, he will come my chest side wall a bit and remove more skin that way.
I will say that I am very pleased with my results.
HTH,
Jennie
I had my thighs done in January, and I paid $8,400 for that and was quoted $5500 for arms. I plan to do those in the fall. The gift from my mom and dad have allowed me to be able to do the other things from our savings.
As far as criteria, WLA really didn't have the same criteria - but I first had to get the referral from my primary who told me that I needed to be at least 12 months out and in his opinion close to my goal weight. At that time, I was about 197, 11 1/2 mos post op, and my body fat % was pretty low - like 25%. Also, you have to be fairly weight stable. They don't want to do the plastic surgery when you have more to lose. I don't believe that I've really lost more on my own. The loss I've had in the past year is do to surgical loss via the plastics. I had 20lbs removed in June, and my weight was around 170 when I had the thigh lift. I've been averaging 163 - 168 post thigh lift depending upon the swelling and fluid in my legs. I keep forgetting to ask how much was removed. The first time I asked, they didn't have a pathology report on the amount of tissue removed, other than what was lipoed off, which was about 4 1/2 lbs. I will have an in office revision to my legs to take off a bit more tissue where my legs rub together at the top of my thighs and revise some dog ears at the end of April, and I will try and remember to ask about how much was removed. At this point my body fat % is about 18%, and I've been told that I really cannot lose more weight. I would like to be in the 150 range, but I've learned that I probably just won't get there. I'm into a size 4/6 pant/skirt and a small/med blouse. Once my arms are done, along with the side boobs, I think I will be a small top all the time.
I had a 10 lb baby 23 years ago, and I know what that did to my tummy and muscles. I had a bad separation, and a small hernia that developed probably from my bypass surgery. I have very defined abs now, and while I have a bit of extra skin above my belly button, I have none below and it is tight and the muscles are very defined. I didn't want the scar down my belly in an anchor cut. Instead, when I have my arms done, he will come my chest side wall a bit and remove more skin that way.
I will say that I am very pleased with my results.
HTH,
Jennie
Jennie
31 lbs lost before surgery
31 lbs lost before surgery
I am hopeful that I will qualify. In your opinion should I start seeing my primary regarding the rashes and the weird smell where my ab flab is now? I had the vsg on Feb 12, and would like to lose 70 more pounds. So in my mind if I make the issues known now I can get them to cover it? Is this how you went about it? I figure I paid for the surgery myself the least they can do since I pay a premium is cover this. Is a 100 lb weight loss going to be enough of a reason for them to cover it. Other than the yr out stable weight and such? Thanks Do you know anyone else who has been lucky enough to have them cover it? Your the only one who answered my Question.
Also where was the first place you went for consults before requesting they transfer you to WLA
thanks again
I
Also where was the first place you went for consults before requesting they transfer you to WLA
thanks again
I
"People are healed by different kinds of healers and systems because the real healer is within." - George Goodheart
Yes, go to your primary EVERY TIME you have a rash. Once you've established a pattern, email them through the KP website. Ask to see a dermatologist to help you resolve the issue. Let your primary know EVERYTHING you have done on your own to treat the problem.
They WILL cover removal of the pannus - remember that is the extra skin that is below the belly button over hanging your pubic bone. From the photos we had to view in our panni removal class, they do not care about how it looks, but getting it off. There is no relocation of the belly button, etc. The amount of weight you have lost will qualify you, but remember, you must be weight stable, considered pretty much at goal taking your extra skin into account, etc. Kaiser routinely does the panni removal for medical reason - rashes that will not resolve - I took all kinds of meds for months, used cremes, etc. Nothing would help until the hot weather was over, and I started using Keifer in my protein shakes daily. Then the rashes finally went away. If you want more done than the panni, you must to either Woodland Hills or WLA. I started in Fontana. I was not happy at all with the plastic surgeon that I first consulted with in the Fontana region out of the Ontario Vineyard surgery center. She has left Kaiser, but I really didn't like her attitude. The dermatologist that I had seen in Fontana was really from WLA and Sunset but was helping in Fontana. He was the derm chieft at Sunset. He said the only thing that would help me was abdominoplasty and a breast lift. Kaiser let me know that they would not, could not cover a tummy tuck, because that includes a cosmetic element ( muscle tightening/repair and belly button relocation), but would cover the portion due to the panni. Also, a panni only cover the skin in the front, from hip bone to hip bone, nothing done in the back. They would also do the lift ONLY, which would have left me an A or AA cup from a DDD. I am happy with the lift and auto augmentation, along with the belt lipectomy.
They WILL cover removal of the pannus - remember that is the extra skin that is below the belly button over hanging your pubic bone. From the photos we had to view in our panni removal class, they do not care about how it looks, but getting it off. There is no relocation of the belly button, etc. The amount of weight you have lost will qualify you, but remember, you must be weight stable, considered pretty much at goal taking your extra skin into account, etc. Kaiser routinely does the panni removal for medical reason - rashes that will not resolve - I took all kinds of meds for months, used cremes, etc. Nothing would help until the hot weather was over, and I started using Keifer in my protein shakes daily. Then the rashes finally went away. If you want more done than the panni, you must to either Woodland Hills or WLA. I started in Fontana. I was not happy at all with the plastic surgeon that I first consulted with in the Fontana region out of the Ontario Vineyard surgery center. She has left Kaiser, but I really didn't like her attitude. The dermatologist that I had seen in Fontana was really from WLA and Sunset but was helping in Fontana. He was the derm chieft at Sunset. He said the only thing that would help me was abdominoplasty and a breast lift. Kaiser let me know that they would not, could not cover a tummy tuck, because that includes a cosmetic element ( muscle tightening/repair and belly button relocation), but would cover the portion due to the panni. Also, a panni only cover the skin in the front, from hip bone to hip bone, nothing done in the back. They would also do the lift ONLY, which would have left me an A or AA cup from a DDD. I am happy with the lift and auto augmentation, along with the belt lipectomy.
Jennie
31 lbs lost before surgery
31 lbs lost before surgery
This is good postive information, thank you for the post. I have lost 70 pounds and my weight is stable. I have been referred to take the class in Fontana on February 2nd. After that, I see a plastic surgeon. At that point, do I ask for a TT and see if I can pay extra? DId you ask or was that offered? I live in Corona, so West LA is no where to drive. Who did you see at Fontana?
really good information however I am seeing the date of 2011 and am wondering did you get Kaiser to approve as I am going to be getting a breast reduction however since losing all 50 lbs I have my lower stomach which gets moist and smells and the powders and creams don't help I have also caught it in my zipper! I know I would only want to get the tummy tuck if I can get the tightening of the muscles and honestly they should cover it as several years ago I had my appendix rupture and while in the hospital I was told to pass gas and I could not and they allowed my stomach to swell so big before they tubed me! which then I was released and ended back to have umbilical hernia surgery which they claimed I was born with but later went to a different doctor and told him how my stomach swelled and he said it sure probably was caused by the swelling it had swelled so bad it was worse then when I was pregnant! I had no belly button and since then I have never been able to tone my stomach so now I am realizing probably tore the muscle wall as I read other post and I will never be able to do on my own so hopefully I can get them to do it all and I don't mind paying some as I have a 10% copay and I am sure some of the other stuff is not covered but while I am having a breast reduction I would sure like to have the tummy tuck and muscles reattached and belly button placed properly while I have the reduction any thing that may help let me know if anyone is doing it in Kaiser hospital in Fontana ca. Doctor Walter Chang will be doing my surgery
Hi Jennie. I just read your post from 2009. Could you please tell me more? I just switched to Kaiser from a good PPO which I couldn't afford anymore. I was all set to have a panniculectomy by a great surgeon but it fell through. I don't trust the surgeons in the Antelope Valley where I live and want to go to West LA like you did. I also need a lot of leg work and upper arms. Can you tell me more about what you had done and how much each procedure was? Thanks, Mary Ritch
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