Tummy Tuck Healing Time

i have a question...

what did it take for your insurance company to cover that? i heard insurance wont cover any plastic surgery? or is it just the luck of the draw?

If your doctor is taking you off work for surgery it would be covered time under FMLA. There was a recent lawsuit were an employer denied FMLA leave to an employee that was out to have a panniculectomy. The employee sued and won.

If there is a medical reason for you to be off work (surgery) it is usually covered under the Family Medical Leave Act. Employers only have a right to know that you are eligible for the leave, that it's for a medical reason, how long you will be out and when you'll return to work. The rest is protected information. FMLA gives you up to 12 weeks of unpaid, protected leave time as long as you meet the eligibllity. Check with your local state employment or labor relations board for more specifics.

Other than that, one sister was back to her desk job after 3 weeks, the other was down for about 1 month (psych nurse), my brother-in-law (telemetry) about 3 months. He had a larger incision with more drains, a minor infection and more excess skin removed. There was no heavy lifting or working out allowed for a while longer - I think 6 months.

Good luck to you.

FMLA does not mean you get paid though...If you have leave time, you can use it, but once that's gone you're kind of SOL.  FMLA  says you have to get the time off, but does not say your employer has to pay you.  You can go to temp disability, and that's not usually close to normal salary.

Blue Cross Blue SHield will cover the tummy tuck if you meet one of two criteria:
!) have lost 100 pounds
2) have a pannus hanging into your pubic area

Apparently if you meet the criteria, there's not even an approval process. I could have scheduled my surgery the same day I saw them because I meet their pre-set criteria...

As for FMLA, I work for a small company, so they are not required to provide FMLA. Even if they did, however, I certainly couldn't afford to go without pay for 6 weeks...

It sounds, though, like 2-3 weeks might be reasonable to return to a desk job... My work is more than happy to make accomodations for me in the office, I just want to make sure I'm capable of something other than lycing on a couch moaning in pain.

Be sure that this is for a full abdominoplasty and not just panniculectomy.  The BC/BS plan I have (as well as the Aetna plan that I had previously) had these as requirements (plus some additional ones undere Aetna) for just a panni removal (which is below the belly button only and does not include muscle tightening).

Edited to add full policy info:
Although some policies are different, the standard BC/BS policy is as follows (and does NOT cover full tummy tuck as you will see by the last line):

Medical Criteria:

Panniculectomy is considered medically necessary when all the following criteria are met:

• The panniculus hangs below the level of the pubis (photo documented); AND
• The patient has experienced a significant weight loss of 100 or more pounds, has been at a stable weight for at least six months and, if the patient has had bariatric (weight loss) surgery, the patient is 18 months post-operative; AND
• Patient has history (documented with office visit records) of recurrent rashes or non-healing ulcers that have not responded to conventional treatment (e.g., topical antifungals; topical and/or systemic corticosteroids; and/or local or systemic antibiotics) for a period of three months; AND
• Demonstrated difficulty with ambulation or interference with activities of daily living (documented).
•  

Policy:

Panniculectomy is considered medically necessary when all the above criteria is documented upon prior medical review. Prospective review is required for BlueCHiP for Medicare and BlueCHiP for RIte Care members and recommended for all other members.

Panniculectomy for other than the criteria listed above is considered not medically necessary and cosmetic.

Panniculectomy is considered not medically necessary as an adjunct to other medically necessary procedures such as, but not limited to, hysterectomy, and/or incisional or ventral hernia repair unless the above medical criteria are met.

Panniculectomy solely for the correction of low-back pain is considered not medically necessary, since the cause of low back pain in most individuals is multi-factorial and the primary cause may not be the abdominal panniculus.

Abdominoplasty is a contract exclusion as it is always cosmetic, not functional.

Lora

It depends, are you just having excess skin removal or the muscle tightening/repair? I am 8 weeks out today and still have not recovered 100% A desk job for me would have been good after 2 weeks. I took 2 and half weeks off then came back 2 and half weeks of light duty which was a desk job, now I'm back in the field and doing most of the things I was before.

Oh and here is the link for the plastic surgery forum 


http://www.obesityhelp.com/forums/plasticsurgery/a,messagebo ard/board_id,4861/

If you are only having a panniculcetomy (only skin below the navel and no muscle tightening) -- which is generally all insurance will cover -- you could go back to a desk job after just a couple of weeks.  With a full tummy tuck, I was off 4.5 weeks and was still walking a bit hunched over when I went back to work... but some people recover much more quickly as far as the level oif muscle pain and tightness.

My short term disability covered the time off (although my plan at the time only paid 50% of my salary for it).

Lora

I should have specified it is BCBS of Michigan. Apparently they're different than other BCBS plans. They will cover the abdominoplasty (with muscle tightening) but not the vertical incision at the top of my abdomen (which is what makes it a "fleur de lis" apparently). I do want the vertical incision, so I'll be paying $900 out of pocket.