panni
well im almost a year out from my gny and ive lost 85 lbs,with a stomach and breasts that have some hanging skin.my question is do I need to go the doctor every month and have it documented that I have a problem with a rash or only once for insurance?I know they dont perform it till your 18 months out.my doc said to just get monistat 7 and that should help.well it does but the minute I stop it the rash comes back...who has had the surgery and what was their steps in order to get the panni or adominoplasty approved by surgery?i have united medical alliance..thanks cathy
There is no need to go every month, but you will definitelly need documentation of more than one visit. You will also need documentation of prescription creams or powders used to attempt to address the rashes.
Be aware, however, that not all insurance companies will cover panniculectomy at all (some consider it cosmetic surgery in all cases), and that -- because the insurance companies know full well that MOST rashes can be controlled with creams or powders -- they usually also require that the panni be a certain size before they will approvie it as medically necessary to remove it. If you only have a small amount of skin they will probably not approve removal. Most of the time, that is also the only thing insurance will cover... they will not cover a tummy tuck (unless you also have a hernia or some otehr condition) and will NOT cover a breast lift.
Even though I had huge batwings and documentation of extensive prooblems with rashes and infections from shaving cuts in my armpits, the insurance company would NOT cover my arm lift.
Lora
Be aware, however, that not all insurance companies will cover panniculectomy at all (some consider it cosmetic surgery in all cases), and that -- because the insurance companies know full well that MOST rashes can be controlled with creams or powders -- they usually also require that the panni be a certain size before they will approvie it as medically necessary to remove it. If you only have a small amount of skin they will probably not approve removal. Most of the time, that is also the only thing insurance will cover... they will not cover a tummy tuck (unless you also have a hernia or some otehr condition) and will NOT cover a breast lift.
Even though I had huge batwings and documentation of extensive prooblems with rashes and infections from shaving cuts in my armpits, the insurance company would NOT cover my arm lift.
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.
If you do have a hernia, will the insurance cover the TT or just hernia repair? Doesn't the TT include tightening the muscles in your stomach? What would be the difference if they just fixed the hernia, wouldn't they still be able to remove some of the extra skin when fixing the hernia? Would this also include a panniculectomy? (My ins will cover a panni with medical documentation that it is medically necessary).
The insurance will have to do separate approvals on the panni and a hernia repair.
Generally, if you have a plastic surgeon do the hernia repair you can get the full TT done (with skin removal) all at once, but if you use a general surgeon for the hernia reapir they will often NOT remove the extra skin.
Lora
Generally, if you have a plastic surgeon do the hernia repair you can get the full TT done (with skin removal) all at once, but if you use a general surgeon for the hernia reapir they will often NOT remove the extra skin.
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.