How do I get started with the process?

Me13
on 10/19/11 9:22 pm
I have Anthem Blue Cross Blue Shield PPO (Connecticut).  Really want this panni. off!

Do I contact the insurance company first? 
Do I have a consult with a PS first?
Do I go through my primary care provider?
Do I go through my bariatric nurse?

I tend to have red, itchy, gross, wet, infected stuff and when I try to exercise (run), it is uncomfortable.

I am hoping my PPO will cover the cost.for getting the panni. removed...


Height: 5'6".  Top Weight/Surgery Weight: 274. (August 2010)
8 weeks out:  219.6.  12 weeks out:  198. 
NORMAL WEIGHT REACHED MARCH 2011 (153 lbs.).
Goal BMI:  In the normal range, please -- somewhere between 22-24 
Clothing size 26/28 (triple X) before surgery in August of 2010. 
March 2011 clothing size:  10/12 (large)

Lap. RNY and Gallbladder Removal, Dr. Choi @ Danbury Hospital, Aug. 2010
   
Laura in Texas
on 10/20/11 2:27 am
I think you have to have a documented history of problems and prescriptions filled through your PCP.

Laura

Laura in Texas

53 years old; 5'7" tall; HW: 339 (BMI=53); GW: 140 CW: 170 (BMI=27)

RNY: 09-17-08 Dr. Garth Davis

brachioplasty: 12-18-09 Dr. Wainwright; lbl/bl: 06-28-11 Dr. LoMonaco

"May your choices reflect your hopes and not your fears."

(deactivated member)
on 10/20/11 2:57 am
I have BCBS also and I just went for my consultation and the surgeon took pics of my GROSS belly and submitted it to the insurance co as reconstructive surgery not cosmetic surgery.  I also had a letter from my family physician stating that I had the same rash your talking about.  It got approved right away and I am now 5 weeks post op.  Good Luck!
jkjstars123
on 10/20/11 1:36 pm - Tama, IA
I'm also ready to start the progress and I'm very interested on the steps to do this. Who do I go to first. Have been documenting my rashes with my surgeon. What now.? What do I do next?
Has anyone had their insurance cover a breast reduction after wls? That is the first thing I want done.

Thanks Julie

  HW 304, SW 291, GW 160, CW 140 H-5'9.5"            

    

Michele816
on 10/23/11 2:39 am
I am interested in how this goes for you.  I live in CT and have Anthem as well.  I get periodic rashes, but the bigger issues for me are the chronic, lower back pain, discomfort with clothing (not that I think the insurance company cares about that one!) and my inability to do certain excercises (running/jogging, stair stepper, anything involving lifting my legs) as the panni slaps against my thighs as well as straining the muscles to the point that I hurt for days and have trouble moving until it subsides.   My panni hangs to about 2 inches above my knees.   I see my surgeon in December and will talk more about plastic surgery then.  If you don't mind, could you keep me posted on your progress with the insurance company?

Thanks!
        
      
dani02
on 10/23/11 9:18 pm - Utica, MI
I have bc/bs anthem also but with a different state. I recently tried to have
a preauthorize done so I could get my panni done. I was denied do to the
fact that
1. I was not 18 months out from surgery
2. my loose skin does not hang 2 inches below my groin
3. 3 months documentation of skin infections that do not clear up with
medical treatment

So if you have infections get to your primary care asap! make sure they
document, and take pictures.

Dani
    
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