Question:
Has anyone ever gotten approved for plastic surgery through BCBS POS ?

Has anyone ever gotten approved for plastic surgery through BCBS POS if so what did they cover & how long did it take to get approved?    — dorothyjj (posted on August 14, 2004)

August 14, 2004
Hi. I have BCBS and was just approved for a tt with hernia repair and a breast lift. I believe the approval took about two weeks. I wrote a letter myself and had letters from my PCP, gastric bypass surgeon, and plastic surgeon. BCBS is very big on documentation. Go to your PCP and have them document things like your weight, rashes, skin ulcers, back and neck pain. My policy required that I have the above problems and have a 100 pound loss, be 18 months post-op, and be at a stable weight for six months. I got out of the 18 month requirement because my hernia needs repaired asap. Check out Tooter's profile for a great letter. It really helped me. Good Luck! Celia 288/130/115
   — Lacy G.

August 15, 2004
I have BCbS PPO, and had no trouble getting a panniculectomy and hernia repair covered. They didn't even require any documentation of related health problems. They asked for pictures from the PS, and once they got those, there was no argument about covering the skin removal. That said, they would cover only the skin removal, not any muscle tightening, so I paid extra for that. They also would not cover the arms or removal of skin from the sides of my breasts. However, since they ocvered the hernia and the panniculectomy, the hospital and anesthesia charges for everything were covered, which saved me quite a lot of money. It took a little over amonth for the approval to come through, but they were not difficult to work with. Best wishes.
   — Vespa R.

February 18, 2010
i just got approved for a thigh lift, arm lift, tummy tuck (taking excess skin off but probably not the suturing of the muscle wall) and a butt lift. i think what did the trick was when i did the appeal (really just for the butt/thigh lift) i cc's the packet to the state health commissioner. it was on the cover letter so the insurance company KNEW they were getting the same packet. insurance companies don't like commissioners knowing what's going on. i am also a govt/county worker but i don't know if that had anything to do with it. me, my dr. and his assistant can't BELIEVE they approved everything. i think i will go for an approval for a reduction also. :) good luck and don't give up!!! that's what they want you to do.
   — cinlu

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