New on this forum and need suggestions,,thanks

Hello everyone, I am 3 yrs out of DS surgery and I am now thinking of PS.  Has anyone had their surgery covered by the BC/BS insurance?  Where should I start?

None of mine was covered.  I was self-pay and went to Dr Sauceda in Monterrey Mexico.  I'll be going back to finish up with an upper body lift in Jan.  We have a fairly active group here on OH, you can click on Dr Sauceda in my siggy line and it'll take you over to our group.

I have a Federal BC/BS PPO and they covered a portion of my lower body lift (the panniculectomy).  The first place to start is with your insurance company.  See if any of the procedures you are interested in are a covered benefit, and find out what the criteria is for being considered medically necessary.  It can vary by employer and location.

If you do have some procedures covered as a benefit, then find a board certified plastic surgeon that has experience with post-bariatric patients and is covered by your insurance.  With my insurance plan, I can only use my benefits with doctors in network.  If I went out of network, I get nothing, depends on your plan.  You will most likely need either your primary care doctor or your plastic surgeon to submit a letter to your insurance company demonstrating that you meet the criteria for medical necessity. 

Hope that is enough to get you started.  Good luck!

My abdominoplasty (with muscle tightening and belly button included) was completely covered by BC/BS doc sent in the request, I was approved and went forward with my surgery a few weeks later

How did  you get BCBS to approve your Plastic Surgery?

Like the other poster, I've also got Empire BC/BS....
The surgeon submitted the paperwork for me after my consult and I was approved shortly afterwards and had surgery when the time worked for me....I think it was like 6 weeks after my consult or so.

I have BCBS FL and they wouldn't touch mine but I had no documentation of skin rash or skin yeast infection from skin overhang.  I believe that would have made a difference if I had had issues.

It depends on which BC/BS you have and which plan. I have Empire and they paid 100% for my panniculectomy / TT with muscle tightening, and now in January they're paying 100% for arm lift, thigh lift, and breast reduction. 

I recommend starting with the insurance company's website, and doing searches for the different procedures, so you can see what their policies are.

Thank you so much for the information everyone!!