Plastic Reconstruction Law for Insurances in CA

Questions anybody familar with the California Plastic Surgery Reconstruction Law?  I am trying to do as much research as possible.


Ok....I am super excited!! My PCP says he will give me the needed referral to see a plastic surgeon!!! I know this doesn't mean that I will be approved for plastic but it means I am on my way!!!!! I told him my body looks like a 72 year old and that it's due to health disease/deformity of obesity. He said I don't mind considering your body has been thru major changes with weightloss! Wish me luck cause I am in there!!

Thank you

It really all depends on your employer and what plan they have opted for.  My employer's plan refuses all plastic surgery regardless of the reason.  Breast CA and malformities from birth are the only ones covered.  I lost over 300lbs and had chronic back pain from my 19 lbs panni, they refused to pay.  I also had my knee come out of place frequently from the "panni" like skin on my thighs.  They refused to pay there also.  Some are very fortunate, others are not.  It's worth calling your insurance company and asking them their policy, if the policy excludes plastics, it doesn't really help to fight it.  It's pretty ironclad.

Good Luck!

I have No Calif Kaiser and they wouldn't do anything.  My panni wasn't big enough, my eyelids weren't down enough (50% of the eye needs to be covered), they might have done a BL, but I really didn't 2 or 3 recovery periods. 

You can give a shout out to Diana Cox, she did get a ruling for abnormal body parts, but Health Net still wouldn't pay when she won her IMR through DMHC here in CA.

Depending on what you want done, you might want to check out Dr Sauceda in Monterrey Mexico.  Click on Dr Sauceda in my siggy line and it'll take you over to his group here on OH. 

I hope the link works. This is something that I bookmarked a long time ago when Diana Cox posted it. Just remember that I have Blueshield of Ca HMO and they approved me for a breast lift and panniculectomy with no problem at all. Good luck to you!

http://www.obesityhelp.com/forums/ds/3588131/Latest-Update-on-CA-Reconstructive-Surgery-no-medical/

Thanks for the heads up. I think this doctor that I ws referred to was a little nasty. He said he is only going to submit for the panni since it's so hard to get anything else approved and even that will be hard to approve. Although he did acknowledge I am in bad need of some boobs!