Question:
Would this be a reason Insurance would pay for PS?

Hi, I'm 17 months post op -127 lbs. I just started the process of looking into plastic surgery. I'm hoping to have my chest, stomach, upper legs and outer hips done. I've been having a couple problems that I'm hoping will help some of my surgery be approved medically. The first one is in between the upper part of my legs, I keep getting infected blackheads/pimples, along with a bunch of smaller blackheads all around them. I went to the Dermatologist the other day, and she has to numb the area of the infected one and cut it out. She said everytime this happens, I have to have it cut out! Doesn't that seem like a reason for Insurance to pay for PS? A couple of other 'gross' things... from the extra skin on my stomach, my bellybutton stays closed up, and if I don't clean and dry it out with a Q-Tip after showering, it will get smelly and infected. I also get rashes in my 'apron' once in awhile, not to mention, backaches. How do I go about getting this approved medically? I have AvMed HMO through the State of Florida Employees Plan. Any suggestions/info would be appreicated! Thanks in advance! :)    — Deena C. (posted on July 23, 2004)

July 24, 2004
All these are excellent reasons and will help your case. Get letters from your dermatologist, primary doctor, WLS doctor and of course the PS you consult with. Start taking pictures AND DATE THEM when your problems are at their worst. A series of dated pictures supports the problems as ongoing. This was one of the comments made in my first denial ---that the photos were not dated. Thwe more you send in, and the grosser it looks, the better your chances are. Don't accept a denial, fight on has high as you can go. You can see what I had to do if you look at my profile. When you take the "belly shots", hold the skin in your hands, making itlook at bad as possible. I am scheduled for 8/17 for my TT, but no chance for me as far as the other areas. Maybe I will hit the lotto and get it done then !!!!!
   — Fixnmyself

July 24, 2004
Yes. DOCUMENT everything and go to the doc each time you have a problem. The INS companies want these notes and presciption/treatment records to prove you have medical issues resulting from the excess skin. A letter from your PS stating your problems won't do...you need the documenattion of the office visits to get approval.
   — DrL