Question:
Can anybody give me advice on appealing breast lift?

I just had my TT done last week. I want to concentrate on getting my breast lift approved by my insurance co, BC/BS of Mich.They denied it how can I appeal? Down 228lbs and happy!Thanks, Beth    — Elizabeth C. (posted on November 4, 2003)

November 4, 2003
I would guess you need to prove medical necessity. I know some one who had years of documentation of back pain who was approved by her insurance. good luck. sonce I dont have medical necessity, if I decide to do it I will save my money and possibly take out a home equity loan.
   — **willow**

November 4, 2003
I dont have much to offer, except appeal. *I am currently in the same boat; just put in mY appeal; but one thing that may happen to you that has happened to me that i will SURELY fight on the appeal is that AFTER your TT you might start experiencing major neck, back and shoulder pain from being uneven. I sure am... and Im going to fight my denial that my breast reduction is NOW a repair of the TT as a 'complication'. I'll keep you posted.
   — star .

November 4, 2003
I have not had this yet, but a friend of mine was approved after documeting her shoulder indentations, from bra straps, her back pain (Dr records) and the skin (yeast) infections she would get under her breasts. She was told that with out a documented medical necessity like these, ins carriers rarely approve.
   — M B.

November 5, 2003
I've heard it is very difficult to get insurance to pay for lifts. Reductions are easier to get, specially if medically documented. Go over to yahoo OSSG groups, there is a plastics group where you should ask your question and probably get more feedback.
   — Cindy R.

November 8, 2003
My PS wrote that "she doesn't want to be any bigger or smaller, just back where they belong" Also, photos speaks volumes. I had the same sx when they needed to be reduced, just now deflated. I also wrote a letter explaining that and it doesn't allow me to exercise like I'd like to as they flop around. I got the lift approved the first time.
   — ZZ S.

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