Insurance and Skin Removal

astrochick18
on 7/5/11 8:03 am - Archer, FL
Does insurance EVER cover excess skin removal?

I have read a couple of posts where people have had their insurance cover various types of plastic surgery after significant weight loss. So, I am just wondering how it would get approved?
                
mjdenco
on 7/5/11 8:27 am

It ALL depends on your insurance. Some cover specific procedures with specific criteria. Others specifically exclude it.
Zombie
on 7/5/11 8:46 am
Some insurance companies will do it but the chances are slim to none. My insurance would'nt cover it, I had to pay out of pocket. I'm getting mine done in August. So you may have to bite the bullet and pay out of pocket or find out if you are covered. Hopefully you would be covered. But in cases like that you still need to provide proof as to why the surgery is medically necessary, like boils or infections, rashes, etc, on the affected areas. You would have to document those incidents with a diary and camera. Good luck. Hope you find the answers you are looking for.

~Paul~

Cicerogirl, The PhD
Version

on 7/5/11 9:14 am - OH
Usually, the ONLY thing insurance will cover is a panniculectomy which is the removal of excess skin below the navel only.  It does NOT icnlude muscle tightening or doing anything about the excess skin above the navel.  Usually insurance requires that the excess skin hang down to a certain place (often below the pubic area) and that there is a 6-month (or other time period) history of rashes and/or infections that did not respond to prescription creams/powders.

In rare cases, tummy tucks have been approved but almost always because a hernia repair was already needed (which is medically necessary, not cosmetic or "reconstructive").

I had as much trouble with rashes in my armpits as I did with rashes under the panni, but despite photos and statements from two physicians insurance refused to cover any part of the arm lift becuase the panniculcetomy is the only reconstructive surgery covered under my plan (other than breast reconstruction following breast cancer).

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

YankeeRose
on 7/5/11 11:01 am - Meadville, PA
I am a new post-op but am already thinking about future need for skin removal (I have over 200 lbs to lose). Anyways, my current insurance will cover a panniculectomy and I have a hernia from a prior abdominal surgery I had 2 years ago and my surgeon said the hernia repair would guarantee me a tummy tuck. I have no idea about arms or thighs or anything else. I would just check with your specific insurance and see what it covers. Good luck.

Tammy
Luck 'o the Irish
HW399/SW362/CW219/GW130
*37 lbs were lost pre-op
       

astrochick18
on 7/5/11 11:18 am - Archer, FL
Thank you for all the input.

For those of you paying out of pocket, how much are you paying? I am just looking for a ballpark because I doubt my insurance will cover any "elective" surgery.
                
Cicerogirl, The PhD
Version

on 7/5/11 11:26 am - OH
What procedure you are talking about having done (tummy? arms? thighs? lower body lift? breasts?)?

Cost really depends on what area of the country you are in (and on the individual surgeon and surgical facility... full service hospitals are more expensive than surgical centers).  I paid $5500 for my arms, $1500 for a mons lift, and about $7500 for the tummy tuck with a surgeon who uses a special surgical facility (my panni removal was covered by insurance).

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

lynnc99
on 7/5/11 12:26 pm
My recent estimate for a tummy tuck at a surgery center is $8500.
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