DENIAL

horkeler1
on 11/23/11 6:38 am - Windsor, CO
well I got turned down for the second time for pannilicutomy....im kinda pissed.their gonna keep giving me the run around and skirting the issue.Im just gonna self pay and get this over with...my surgeon quote is about 3000.00 for panni surgery is that resonable or should I look else where.I live in colorado and have united medical alliance insurance.its always gonna come down to "its cosmetic"no matter if your pannius hangs to your knee's"its B.S no matter how many rashes or infections or meds you were precribed it will always be considered "cosmetic"what a waste of time and anxiety and got my hopes up,im soo disappointed and upset.so now the next step is self pay,which I dont have laying around or getting a bank loan with interest or using a surgery loan option with interest or borrow from a family member with no interest.they all seem overwhelming..I dont know im really confused but determined to get this done,Ive come this far and cant give up now to really reach my ultimate goal,Ive lost the weight and now I need to go to the next phase and start the body contouring phase to complete this journey.I'll pray on it and think and think I'll figure it out just thought someone has any good experiences or suggestions or ideas on which way I should go...I need help!!!!Thanks CAT
Iam_with_the_Band
on 11/23/11 1:30 pm
I live in Colorado too.  I have United Healthcare Centura.  They have the same exclusion.  I didn't fight it.  I went with Dr Sauceda in Monterrey Mexico and never looked back.  I took out a loan from my 401K and am paying myself back.  You can take out 50% of your balance and then pay it back to yourself at 4% interest.  No penalty.  It's really a good plan.

12/09 and 6/11, 9 skin removal procedures with Dr. Sauceda in Monterrey Mexico
Revised to the Sleeve after losing 271 lbs with the LapBand. 

Lizzy25
on 11/24/11 2:26 pm
 I'm so sorry, that's awful. Getting money out of insurance companies is like trying to get blood out of a stone. 

$3,000 seems very reasonable for a panniculectomy. I paid $11,500 for my fleur de lis abdominoplasty + lipo, so that's a fraction of the cost. 

Have you seen pictures of panniculectomies done by the doctor you want? I ask because the results can really vary widely, and can be kind of ugly in the wrong hands (as with anything else). You need to make sure that your PS will still be meticulous about scar placement. I've just seen some panniculectomies that didn't look very good. Have you thought of just going to Mexico and paying for a regular tummy tuck? Of course there are issues with that too, because you'd need to travel there, and you wouldn't be able to see your PS for aftercare after you returned home so if you had any issues you'd probably have to pay another doctor to attend to them. Health insurance won't pay for complications related to elective surgeries (I learned that the hard way, $4,000 later). So you've gotta have a really good plan in place with whatever doctor you end up seeing. 

As WLS patients we tend to have many more complications and our recoveries are harder because we just have so much more skin to remove, the surgeries are longer and more complex. There's more cutting. So I hope you can plan as much in advance as possible for people to help you, what you'd do in case of complications, etc. If even a single complication would put you in the poor house then maybe you'd be better off waiting a bit longer until you've got more financial flexibility. 

I have read the terms on some surgery loans (carecredit etc) and they're kind of scary. If you're late on a single payment they slam you with an APR of 26.99% (ROBBERY!) which is retroactive and applies to the entire amount loaned, not just the amount you still have left to pay. I think borrowing from family or a bank would be better than risking that kind of situation. 
"The greatest challenge to any thinker is stating the problem in a way that will allow a solution." -Bertrand Russell
5'9 HW: 297 GW: 160 CW: 161
(deactivated member)
on 11/25/11 12:04 am
Ditto on the 401k loan that's what I did to pay for WLS and plastics, only 4 more years and 16000 to go. Maybe look into a credit card with 0% for 12 months or more on puchases or put it on a credit card then transfer the balance. Credit unions are doing loans right now for the holidays with good interest rates as well.

Three grand doesn't strike me as bad at all but make sure it includes muscle tightening you will want that for sure. The surgeons here in NE that do the bariatric procedures do a panni removal for 3500 so your price isn't bad at all. You want to look into extra insurance for plastics to cover medical expenses incase something bad does happen.
 http://www.cosmetassure.com/Shared/AboutCosmetassure

I had blood clots, but my hernia was done at same time so my insurance covered hospital stay so it was never an issue for me.

Good luck
Bubba
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