TUMMY TUCK VS PANNIS REMOVAL

Can anyone tell me if UHC pays for either surgery.  If so what are the requirements.  I am only 2.5 months out but I now have a saggy belly flap covering up the "GOODS" and do not think I want to keep it.  I am also thinking a breast lift will be in order?  Any info is appreciated...

Insurances vary depending on what the employer wants to cover or not cover.  If they cover anything due to hanging skin it would be the panni which is skin removal only.  I'm not sure if a TT may be possible if there is a hernia as well.

Some insurances (based on what the employer has contracted for) specifically exclude reconstructive/plastic surgery related to weight loss.

Some insurances specifically exclude plastic surgery, but will pay for some reconstructive surgery based on medical need (repeated rashes, skin damage, muscle damage, etc.). For this reason, my doctors all recommended that when I contacted my insurance, I did NOT mention plastic surgery but instead asked about reconstructive surgery due to damaged skin/muscles.

Some will pay for either based, again, on medical need.

Start now to call your primary care physician to document ANY rashes, sores, infections, muscle issues. Most physicians recommend that you be done with weight loss for 12-18 months before considering any plastics/reconstruction, unless there is a significant medical need to do it sooner, so you have plenty of time to get all documentation in order.

I am suggesting you do your documentation first, because your insurance may well change before you're ready to seek out reconstruction/plastics, so rather than tailor your request for what you have now, collect and have your PCP document the broadest spectrum of info you can.

Best of luck when it's your time -

Compelely depends on what rider your employer has purchased. I would recommend reading your policy completely to see if it is included or not. I already had my PS but was bored at work. We changed insurance compaines to UHC 5 months after BCBS covered the panni portion of my surgery. The policy my company has w/ UHC completely excludes reconstructive surgery for panni removal or any type of skin removal/recontruction associated w/ WLS. Glad I had it done months before.

Read your policy or call your insurance company and ask the questions.

It is VERY raare to get a tummy tuck covered by insurance unless you have a hernia that nees reparied (and sometimes not even then).  SOME policies cover a panniculectomy IF you meet all the criteria (usually a history of rashes that did not respond to prescription creams/powders-- and yiou have to show evidence of everything you have already tried)), it has to hang down a certain amount, etc.).  EVen if UHC covers it for people who work for one company it does not mean they will cover it for ALL company policies.  What they cover depends on what your employer asked them to cover... so you will ahve to conatct them with your policy number and ask if they cover it at all and, if so, what the conditions are for showing "medical necessity".  NO insurance will cover a breast lift.

Lora

Very interesting post as I am scheduled for a hernia repair and tummy tuck in August!  I wasn't even planning to ask if my insurance would pay for the tummy tuck but, I may now that I've read Lora's response!  Thanks Lora!  Who knows?  All they can say is yes or no! 

Best of luck to everyone!

Absolutely!  If they say "no" (as mine did) you haven't lost anything... and they MIGHT say "yes"!

Lora